多层螺旋CT血管造影对主动脉夹层的诊断价值及临床应用

Diagnostic Value and Clinical Application of Multi-slice Spiral CT Angiography in Aortic Dissection

目的探讨多层螺旋CT血管造影(CTA)在主动脉夹层中的诊断价值及临床应用。方法回顾性分析2010年2月-2011年4月35例行CTA检查的主动脉夹层患者,所有患者原始数据在图像后处理工作站采用多平面重建、容积再重建、最大密度投影等方法进行主动脉成像。由2名有经验的放射科副主任医师进行诊断。结果 35例均可明确显示主动脉夹层的真假腔、内膜片及破裂口部位。Ⅰ型12例,Ⅱ型3例,Ⅲ型20例;累及左锁骨下动脉5例,左颈总动脉2例,无名动脉2例,腹腔干3例,肠系膜上动脉4例,左肾动脉3例,右肾动脉2例,右髂总动脉受累6例,左髂总动脉受累8例,其中双侧髂总动脉均受累4例;合并动脉瘤3例;壁内血肿4例;所有患者均显示了单一或多发破口。结论 CTA及图像后处理技术能快速、准确地诊断主动脉夹层,为临床治疗方案选择提供重要的影像学依据。

Objective To evaluate the diagnostic value and clinical application of multi-slice spiral CT angiography （CTA） in aortic dissection. Methods The clinical data of 35 patients with aortic dissection having undergone multi-slice spiral CT angiography were studied retrospectively. The volume data were transferred to the workstation for image post processing by performing multiplanar reconstruction （MPR）, volume rendering （VR） and maximum intensity projection （MIP）. All images were diagnosed by two experienced associate chief physicians of radiology. Results The true lumens, false lumens, the dissection membranes and tear crevices were showed definitely in all the 35 cases. Twelve cases were type I , 3 were type 11,20 were type 11I. Among them, the lesion involved left subclavian artery in 5 patients, left common carotid artery and innominate artery in 2, celiac trunk in 3, superior mesenteric artery in 4, left renal artery in 3, right renal artery in 2, right common iliac artery in 6, left common iliac artery in 8, bilateral common iliac artery in 4, combined aneurysm in 3, and intramural hematoma in 4. Single or multiple crevasses were showed in all cases. Conclusion Multi- slice spiral CT angiography and comprehensive post-processing techniques can diagnose aortic dissection quickly, and can provide significant information for clinical therapeutic schedule.