超声及64排螺旋CT血管造影在主动脉壁内血肿诊断中的应用研究

Ultrasound and 64-slice Spiral CT Angiographic Diagnosis of Aortic Intramural Hematoma

目的:探讨64排螺旋CT血管造影及超声在诊断主动脉壁内血肿(IMH)中的应用价值。方法:2007年1月至2009年6月间529例行主动脉血管成像及超声检查,其中诊断壁内血肿21例,男16例,女5例,平均年龄61岁。分析其影像特征。结果:64排CTA诊断IMH21例,明显高于超声诊断的7例(P<0.05)。IMH的CTA表现为半月状、环状增厚的动脉壁内血肿,伴有钙化灶内移(17例)、穿透性溃疡(13例)、主动脉粥样硬化(13例)及胸腔积液(15例);按Standford分型可分为A型9例和B型12例,2例伴主动脉真性动脉瘤。结论:64排螺旋CT血管造影可清晰显示主动脉壁内血肿的直接和间接征象,是一种无创而有效的诊断方法,优于超声。

Purpose： To study the value of ultrasound and 64-slice spiral CT in the diagnosis of aortic intramural hematoma（IMH）.Methods： Between January 2007 and June 2009,529 patients were scanned by 64-slice spiral CT and ultrasound.Out of which,21 patients（male 16,female 5）were aortic IMH.The clinical data and image findings were analyzed.Results： The CT angiographic（CTA） features of aortic IMH were as follows：displacement of intimal calcification（17 cases）,penetrating ulcer（13 cases）,atherosclerosis（13 cases）,pleural effusion（15 cases）.Among the 21 cases,Stanford A type and Stanford B type were involved in 9 and 12,respectively.The complication signs were true aneurysm（2 cases）.The diagnostic accuracy of CT were 100%,while the diagnostic accuracy of Ultrasound were 33.3%.Conclusion： 64-slice spiral CT is a noninvasive,effective method for the diagnosis of aortic IMH and can show the direct and indirect signs of aortic IMH.64-slice Spiral CT has its clear advantages.All these signs have important value for clinical diagnosis and treatment.