单纯性主动脉壁内血肿的16层CT表现(附4例分析)

Features of 16-slice spiral CT for simple aortic intramural hematoma(analysis of 4 cases)

目的:探讨单纯性主动脉壁内血肿(intramural hematoma,IMH)的16层CT检查方法和影像表现。方法:4例单纯性IMH患者行16层螺旋CT平扫与增强扫描,使用心电门控,1例加扫静脉期。重组方法包括MPR、MIP和VR。结果:4例单纯性IMH均为B型。主要CT表现:主动脉壁呈半月形或环形增厚,CT平扫呈高密度,增强后无强化,1例静脉期强化;内膜钙化内移位2例;2例内膜多处渗漏。MPR、薄层MIP清晰显示血肿部位、厚度、累及范围及有无并发症。2例单纯性IMH采用内科保守治疗。2例IMH腔内隔绝术。结论:单纯性IMH的16层CT检查应包括平扫与双期增强。CT检查有助于单纯性IMH分型,具有重要的临床应用价值。

Objective：To investigate features and mechanism of 16-slice spiral CT for intramural hematoma（IMH）.Methods：16-slice spiral CT plain and enhanced scans of 3 cases were performed with electrocardio-gating,1 case had delayed scan multi-planar reformat（MPR）,post-processing technique included multi-planar reformation（MPR）,maximum intensity projection（MIP）,volume rendering（VR）.Results：3 cases were Stanford type B.The CT findings showed as following： crescent or circular thickening of the aortic wall.CT plain scanning showed high density,no aggregation after enhanced scanning;2 cases calcified intima shift endocentrically;multiple leakages（1 case）.MPR and thin MIP revealed the location,thickness,extension and complication of the simple IMH.2 patients underwent conservative treatment,2 cases with multiple leakages was treated by endovasculr stent-graft repair.Conclusion：16-slice spiral CT examination of simple IMH should include plain and dual-phase contrast scan.The imaging features of simple aortic IMH can assessed on 16-slice spiral CT.