摘要
目的探讨双源CT对穿透性粥样硬化性主动脉溃疡的诊断价值。方法将18例临床可疑主动脉病变就诊患者进行双源螺旋CT检查，采用多种图像后处理技术，包括容积重组（VR）、多平面重组（MPR）、曲面重组（CPR）及最大密度投影（MIP）并按诊断标准进行分析。结果18例发现20个病灶。均表现为主动脉壁上的溃疡状突起，龛影1：1部与主动脉腔相连，可表现“狭颈征”，尤其在曲面重组（CPR）图像上明显。伴有局部或弥漫性主动脉壁内血肿（IMH）。间接征象包括主动脉壁钙化斑块、主动脉扩张等。双源CT血管成像均能够对主动脉溃疡及主动脉壁内血肿准确诊断，相对于单源多层螺旋CT患者的X线剂量明显减少，其后处理三雏重建技术明显发展，可作为主动脉病变的首选检查方法。结论双源螺旋CT是一种快速、无创的血管成像检查方法，对于穿透性粥样硬化性主动脉溃疡的直接、间接征象及并发征象能够更清晰更立体的显示，对临床的诊断与治疗提供可靠依据。
Objective To estimate and analyze the clinical value of dual--source CT angiography（DSCTA） in displaying the penetrating atherosclerotic aortic ulcer （PAU）. Methods 18patients were suspected aortic disease with DSCTA,with surestar technique, excretory2phase images were trans- ferred to the workstation and performed shaded volume rendering （VR）, multiplanar reconstruction （MPR）, curved planar reconstruction （CPR） and maximum intensity projection（MIP）. And estimate the diagnostic typing with diagnostic denominator. Result 20 lesions were found in 18patients. UI- cer21ike aortic projections were observed, and connected with aortic ca＇city, where＂narrow neck sign＂was shown, especially obviously on CPR images, and localized or extensive IMH were observed too. The indirect signs included calcification of aortic wall and dilatation of aorta. Duai-- source CT angi- ography were able to accurately diagnose the intramural aortic hematuma（IMH） and penetrating atherosclerotic aortic ulcer （PAU）, it is relative to other diagnostic method has obvious advantages. Conclusion As a rapid noninvasive examination, DSCTA is opposed to the single source CT in patients with X ray dose significantly reduced;DSCT three--dimensional reconstruction of post--processing technology developed significantly . It is for IMH and PAU direct, indirect signs can be clearer and more three--dimensional display. Provides various kinds of information for the clinical di- agnosis and treatment.
