多层螺旋CT对主动脉壁间血肿的影像诊断

目的评价多层螺旋CT诊断主动脉壁间血肿的价值。方法采用GEMSCT扫描机，连续增强扫描，对20例主诉急性胸背痛患者进行MSCT检查并诊断为主动脉壁间血肿。结果主动脉壁间血肿的直接征象：主动脉壁呈新月形或环形增厚≥5mm，无内膜破裂形成的主动脉征象。间接征象：钙化内移5例，穿孔机透性溃疡4例，主动脉壁粥样硬化改变17例，内膜渗漏2例。并发征象：心包积液4例，胸腔积液11例，主要分支血管受累3例，主动脉夹层3例。结论MSCT能为主动脉壁间血肿的诊断和治疗提供重要信息。

Objective To evaluate the value multi -slice spiral CT（MSCT） in the diagnosis of aortic intramural hematoma （AIH）. Methods Twenty patients who complained of acute chest and back pain were scanned with an MSCT scanner （Definition） using contrastenlhanced continuous volumes canning （CVS） for establishing the diagnosis of AIH. Results The direct features of AIH in MSCT included crescent or circular thickening（ 〉 5mm） of the aortic wall without signs of lumen formation resulting from intimal rupture. The indirect feature included calcification ingression （5 cases ）, penetrating ulcer （4 cases ）, atherosclerosis （17 cases） ,and leakages （2 cases）. The complicating features included pericardial effusion （4 cases ）, pleural effusion （11 cases）, involvement of the large branches（ 3 cases） , aortic dissection（ 3 cases）. Conclusion MSCT can provide important information for the diagnosis and treatment of AIH, and can be usrful for follow - up observation of the patients.