MSCT诊断不典型主动脉夹层的价值

Clinical Application of Multi-slice CT Angiography in Atypical Dissecting Aneurysm of Aorta

目的回顾性分析不典型主动脉夹层的CT表现,探讨MSCT诊断不典型主动脉夹层的价值。方法分析42例不典型主动脉夹层,并参照Stanford分类法进行分型。结果 42例不典型主动脉夹层,26例为A型,16例为B型。CT表现:(1)主动脉呈半月形或环形增厚,CT平扫时呈高密度,CT值约为50～80 Hu,增强后无强化,与强化主动脉管腔对比反呈低密度。治疗后复查,壁内血肿因吸收而演变为慢性血肿,厚度及长度减小,CT平扫时密度较前降低而呈低密度。(2)内膜钙化向内移位7例。(3)主动脉管腔狭窄、变形16例。(4)全部病例主动脉均有不同程度的动脉粥样硬化改变:主动脉壁不规则增厚、钙化。(5)并发心包、纵隔及胸腔积液和积血共38例。结论 MSCT清楚显示血肿部位、厚度、累及范围及有无并发症,为临床诊治及预后提供了重要的信息,是一种安全、有效和无创的诊断方法。

OBECTIVE To assess the clinical value of muhi-slice CT（MSCT） angiography for the diagnosis of atypical aortic dissecting aneurysm. METHODS The materials of MSCT angiography and its post-processing images in 8 patients with atypicalaortic dissecting aneurysm were retrospectively analyzed. RESULTS Ascending aorta, aorticarch, descending aorta, abdominal aorta, bilateral commoniliac artery, bilateral internal and external iliac artery, celiac trunk, superior mesenteric artery and bilateral renal artery were clearly assessed on volume rendering （VR） and multi-planar reformation（MPR）images with high image quality, good contrast and without ladder-like artifact along the contour of aorta. Of the 8 patients, there were intramural hematoma in five patients, no back cavity communications were revealed in three patients. CONCLUSION Atypical aortic dissecting aneurysm could be clearly assessed by using MSCT vascular imaging techniques which are non or mini-invasive and provide valuable information for the diagnosis and treatment in clinical practice.