MSCTA在DebakeyⅢ型主动脉夹层动脉瘤中的应用

The application of MSCTA in Debakey Ⅲ aortic dissection

目的:探讨多层螺旋CT血管造影在DebakeyⅢ型主动脉夹层动脉瘤诊断中的应用价值及其与DSA的比较研究。方法:研究56例拟行腔内带膜内支架置入术的DebaleyⅢ型主动脉夹层动脉瘤患者的MSCTA表现,分别测量第一内膜片裂口位置、大小,左锁骨下动脉开口平面的主动脉最大径等参数,并与DSA检查结果进行比较。结果:MSCTA与DSA对DebakeyⅢ型主动脉夹层动脉瘤的诊断符合率达92%,MSCTA还可发现主动脉之外的其他疾病。MSCTA与DSA对内膜片第一裂口的大小及位置的测量无明显差异;对左锁骨下动脉开口平面的主动脉最大径的测量有明显差异,DSA的数值小于MSCTA。结论:MSCTA可以明确诊断DebakeyⅢ型主动脉夹层动脉瘤,同时还可发现主动脉之外的其他疾病。MSCTA对主动脉夹层动脉瘤的各个参数的准确测量可帮助和指导腔内带膜内支架置入手术,可作为DebakeyⅢ型主动脉夹层动脉瘤诊断及腔内带膜内支架置入术的术前评估中首选的影像学检查方法。

Objective：To discuss multi-sLice CT angiography （MSCTA）diagnosis in Debakey Ⅲ aortic dissection and after endoluminal stent grafting application value in endoluminal stent grafting .Methods ： We studied 56 patients＇ MSCTA image caused by Debakey Ⅲ aortic dissection before endoluminal stent grafting. We measured position and size of the first tears of intima and the biggest diameter of aorta at basic left subclavian aorta etc to identify difference between MSCTA and DSA. Results：Coincidence rate between MSCTA and DSA is up to 92% in diagnosing Debakey Ⅲ aortic dissection, and we found other diseases in MSCTA image excessively. There is not obvious difference in measureing position and size of the first tears of intima between MSCTA and DSA, there is clear difference in measureing the biggest diameter of aorta at basic left subclavian aorta between MSCTA and DSA, and diameters in DSA are smaller than those in MSCTA. Conclusion：We can diagnose Debakey Ⅲ aortic dissection definitely and other diseases except for aorta simultaneously. Exact measures in aortic dissection＇s parameter not only help but also guide endoluminal stent grafting, wlfich can be regarded as the first selection of imaging technology in diagnosis and evalating endoluminal stent grafting before operation.