多层螺旋CT血管成像诊断主动脉壁内血肿的临床应用

Application of multi-slice computed tomographic angiography for diagnosing aortic intramural hematoma

目的:探讨多层螺旋CT血管成像诊断主动脉壁内血肿的临床应用价值。方法:对30例拟诊主动脉壁内血肿患者行MSCT血管成像。采用容积再现(VR)、多平面重组(MPR)、曲面重组(CPR)及最大密度投影(MIP)重组图像。由两名经验丰富的心血管影像医师评估,明确血肿的部位和范围。结果:30例壁内血肿中Stanford A型1例,Stanford B型29例。合并穿透性动脉粥样硬化性溃疡(PAU)17例,占56.7%。合并胸腔积液8例,心包积液1例。结论:MSCTA能清晰显示病变特征和累及范围,是主动脉壁内血肿重要检查方法。

Objective：To assess the value of multi-slice computed tomographic angiography（MSCTA） for diagnosing aortic intramural hematoma（IMH）.Methods：A total of 30 patients who had onset of sudden back pain or chest pain within 4 to 6 hours underwent MSCTA.Images were reconstructed by volume rendering technique（VRT）,multiplanar reconstruction（MPR）,curved planar reformation（CPR） and maximum intensity projection（MIP） techniques.Two experienced cardiac radiologists assessed the location and extent of IMH.Results：In 30 patients with IMH,1 patient was Stanford type A,29 patients were Stanford type B.Seventeen patients（56.7%） had penetrating atherosclerotic ulcers（PAU）.Eight patients had pleural effusion and one had pericardial effusion.Conclusion：The features and extent of IMH could be visualized on MSCTA.MSCTA was the most important diagnostic tool for IMH.