多层螺旋CT血管造影诊断急性主动脉夹层的临床探讨

Clinical application of multi-slice spiral CT angiography in acute aortic dissection

目的探讨多层螺旋CT血管造影(MSCTA)在急性主动脉夹层(AD)的临床应用价值,提高急诊早期诊断水平。方法回顾性分析52例AD患者的16层螺旋CT血管造影(16SCTA)资料。结果按DeBakey分型,Ⅰ型9例、Ⅱ型7例和Ⅲ型36例。轴位图像及多平面重建(MPR)、曲面重建(CPR)清晰显示真假腔(100%)、内膜片(100%)、内膜破口39例(75%)及血栓10例(19.2%)。最大密度投影(MIP)和容积再现(VR)能显示管壁钙化情况和病变空间关系。结论 MSC-TA对急诊早期诊断和指导治疗具有重要临床价值。

Objective To explore the clinical applicable of multi-slice spiral CT angiography （MSCTA）in the diagnosis of acute aortic dissection （AD） so as to improve early diagnosis. Methods The 16-slice spiral CT angiography（16SCTA） imaging data of 52 patients with AD were retrospectively reviewed. Results According to DeBakey＇ s classification, 52 cases included type Ⅰ of 9 cases, type Ⅱ of 7 cases, and type Ⅲ of 36 cases. Transverse images, multi-planar reconstruction（MPR） , and curved-planar reformation （CPR） clearly showed the true and false lumen （ 100% ）, intimal flaps （ 100% ）, intimal tear （39 cases, 75.0% ） , and thrombus inside the false lumen （ 10 cases, 19. 2% ）. Maximum intensity projection （MIP） and volume rendering（VR） displayed the space relationship and calcification of aorta. Conclusion MSCTA has the important clinical value used for early diagnosis and guiding treatment with suspected AD.