主动脉窦瘤的造影诊断与手术病理对比研究

Aortic Sinusal Aneurysm: A Comparison of Angiographic Signs with Pathologic Findings

目的：通过２０例主动脉窦瘤的造影诊断与手术病理对比观察，分析其影像病理基础和漏、误诊原因，以期进一步提高造影的正确诊断率。材料与方法：２０例术前均行主动脉根部造影，４例并行左室造影。２０例均行心内直视手术修复。将造影表现与手术结果进行对比。结果：造影诊断右冠窦瘤１６例（未破４例，破入右室流出道１２例），无冠窦瘤破入右房２例，主动脉瓣脱垂２例。手术证实右冠窦瘤１５例（未破４例，破入右室流出道１１例），无冠窦瘤破入右房３例，主动脉右瓣脱垂２例。造影诊断与手术结果相符１５例（７５％），漏诊２例，误诊３例。结论：主动脉根部造影是主动脉窦瘤术前重要的诊断手段，但需结合其他影像手段并获得高质量的造影图像以提高诊断符合率。

Objective: To improve the diagnostic accuracy of aortic sinus aneurysm with angiography. Materials and Methods: Preoperative angiography of aortic root and surgical repair were performed in 20 patients with abnormal aortic valve. The angiographic signs were compared with the surgical and pathological findings. Results: Angiographic examinations revealed right aortic sinusal aneurysm in 16 cases (4 unbroken, 12 ruptured into the right ventricle), back aortic sinusal aneurysm ruptured into right atrium in 2 cases and aortic valve prolapse in 2 cases. The operations confirmed right aortic sinusal aneurysm in 15 cases (4 unbroken, 11 ruptured into the right ventricle), back aortic sinusal aneurysm ruptured into the atrium in 3 cases and aortic valve prolapse in 2 cases. The angiographic diagnosis was correspondent with surgical results in 15 cases (75%), 3 cases were misdiagnosed and 2 cases missed diagnosis. Conclusion: The angiography of aortic root is an important preoperative examination for the diagnosing of aortic sinus aneurysm. To improve diagnostic accuracy, high quality angiograms and a combination with other imaging technique are necessary.