CTA诊断孤立性肠系膜上动脉夹层动脉瘤的体会

Experience of isolated superior mesenteric artery dissection with computed tomography angiography

目的探讨64层螺旋CT对孤立性肠系膜上动脉夹层动脉瘤(Isolated Superior Mesenteric Artery DissectionISMAD)的诊断价值。方法回顾性分析我院10例ISMAD的64层螺旋CT的CTA表现及临床治疗措施,并根据Yun的标准进行分型。结果 64层螺旋CT轴位图像及后处理图像MPR、MIP、VR均能清楚显示肠系膜上动脉夹层的真、假腔和内膜瓣,其中Ⅰ型4例,Ⅱ型5例,Ⅲ型1例;9例行内科保守治疗,1例行腔内支架治疗。结论 64层螺旋CT有助于ISMAD的诊断和临床治疗方法的选择,对降低肠缺血、坏死的发生率具有重要的诊断价值。

Objective To evaluate the features of isolated superior mesenteric artery dissection with 64 slices CT.Methods The CTA features and the clinical data of isolated superior mesenteric artery dissection in 10 patients were reviewed retrospectively.Yun＇s classification was analyzed.Results 64 slices CT demonstrated the true and false lumens and the intimal flap in all patients.The images of MPR,MIP,VR also showed clearly.According to Yun＇s classification,there were four typeⅠ,five type Ⅱ,and one type Ⅲ.Nine patient were conservative treatment,one patient needed endovascular therapy.Conclusions 64-slices CT is useful for the diagnosis and the clinical therapy of isolated superior mesenteric artery dissection,and has important clinical diagnostic value.