超声、MR、CT、X线诊断主动脉夹层的比较

Comparative study of ultrasound,MRI,CT and X-ray in the diagnosis of aortic dissection

目的：比较超声、MR、CT及X线对主动脉夹层的诊断价值。方法：2005—01～2008—09经手术病理证实的26例主动脉夹层患者，26例均经超声、X线检查，17例经MR及CT检查，重点观察超声主动脉声像，内膜有无撕裂及撕裂部位，真假腔血流情况，主动脉瓣有无受累及瓣膜反流情况、心包积液、左室收缩功能等。结果．26例超声诊断25例，其中12例为DeB—bakeyI型，占46．2％，5例为Ⅱ型，占19．2％，9例为Ⅲ型，占34．6％，I型最常见。19例中量以上主动脉瓣反流，7例少量主动脉瓣反流，9例少一中量心包积液。16例LVEF％及LVFS％降低。17例经MR及CT检查诊断15例，26例胸片提示主动脉增宽，心影增大。结论：超声可作为诊断主动脉夹层的首选检查项目。

Objective： To compare the diagnostic value of ultrasound, magnetic resonance imaging （MRI）, computed tomography （CT） and X -ray for aortic dissection. Methods： From January 2005 to September 2008, 26 patients with aortic dissection were confirmed by operation and pathology. Ultrasound and X -ray were performed in all of the 26 patients and 17 patients were examined by MRI and CT. The imaging of aorta, intimal tear entry, blood flow of true and false lumen, aortic valve regurgitation, pericardial effusion and left ventricle systolic function were observed. Results： Twenty -five aortic dissection patients were diagnosed with ultrasound in 26 patients. Twelve patients were DeBakey type Ⅰ, five were type Ⅱ, and nine were type Ⅲ. The moderate aortic valve regurgitation was observed in 19 patients, the mild aortic valve regurgitation in 7, and the mild - moderate pericardial effusion in 9. The left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） were decreased in 16 patients. Fifteen patients were correctly diagnosed by MRI and CT in 17 patients. The chest X - ray only showed cardiomegaly and broadened aorta in the 26 patients. Conclusion ： Ultrasound is the preferred diagnostic method for aortic dissection.