64层螺旋CT对主动脉夹层的应用价值

The application of 64 slice multi-detector CT in aortic dissection

目的:探讨64层螺旋CT诊断主动脉夹层的临床价值。方法:39例拟诊为主动脉病变的患者作为本组研究对象,对所有患者行CT平扫及增强扫描。CT平扫图像上观察内膜钙化的移位、主动脉直径扩大、心包和/或纵隔积血、胸腔积液/血。并对A型和B型主动脉夹层的平扫征象进行统计学比较。CT增强图像上观察低密度的内膜瓣、破口(入口和再入口)、真假腔及主要动脉分支受累情况。结果:21例主动脉夹层中,CT平扫观察到钙化的内膜瓣移位9例(42.9%),主动脉直径增宽8例(38.1%),心包和/或纵隔积血8例(38.1%),胸腔积液/血5例(19.0%)。CT增强扫描对主动脉夹层内膜瓣的显示率达100%(21/21),对真、假腔的显示率为100%(21/21),对破口的显示率为85.7%(18/21)。8例(38.1%)弓上血管受累,5例(19.0%)内脏血管受累。结论:64层螺旋CT对主动脉夹层有较高的诊断价值,能较好的显示夹层的真假腔、内膜瓣及破口,并且可以显示主要动脉受累情况,为外科的手术治疗提供重要信息。

Objective： To investigate the value d 64 slice multi-detector CT in diagnosing aortic dissections.Methods： Thirty-nine patients with suspect aortic diseases were evaluated in this study with Siemens 64 slices CT scanner. All of the patients were performed with non-contrast and contrast scans. The presence of intimal calcifications of displaced towards the aortic lumen, an aorta with an enlarrged diameter, hemopericardium or hemomediastinum, pleural effusion were observed on non-contrast scans. The appearance of A and B type aortic dissection on non-contrast images were compared. The low-density intimal flap, the entrance and re-entrance, the true channel and false channel, the involvement of collateral branches of the aorta were observed on contrast images. Results： Intimal calcifications of displaced towards the aortic lumen were showed in 9 cases（42.9%） on non-contrast images, an aorta with an enlarged diameter in 8 cases （ 38.1% ）, hcmopericardium or hemomediastinum in 8 cases （38.1% ）, pleural effusion in 5 cases （ 19.0% ）. On contrast images, the demonstration rate dinitial flap, the true channel and false channel, and tear entrance were 100% （21/21）, 100% （21/21）, and 85.7 % （ 18/21 ） respectively. There were 8 cases （38.1%） with the supra-aortic arteries involved, 5 cases （ 19.0% ） with the abdominal visceral branches involved. Conclusion：The 64 slice multi-detector CT are help to the diagnosis of aortic dissections.The intimal flap, the true and false channel and the tear entrance can be displayed well, as well as the supra-aortic arteries and the the abdominal visceral branches involved.