主动脉弓离断的影像学表现及诊断价值

Imaging Diagnosis of Interrupted Aortic Arch

目的 比较不同的影像学检查方法对主动脉弓离断 (IAA)的诊断价值和限度。材料与方法 对 10例确诊为 IAA的各种影像学资料进行分析、比较。结果 胸片诊断仅有某些提示意义。升主动脉造影可以明确诊断并分型 ,但为有创性检查 ,有时需多次插管 ,多部位造影才能充分显示病变。超声显示心内畸形好 ,但显示主动脉弓降部畸形欠佳。螺旋 CT血管成像 (SCTA)能立体地显示主动脉弓降部畸形 ,但不能显示心内畸形。电子束 CT(EBCT)优于螺旋 CT,但尚未普及。MRI亦能显示主动脉弓降部畸形。结论 SCTA、EBCT或

Objective To compare the diagnostic value and limitation of several different imaging methods for the interruption of aortic arch (IAA). Materials and Methods Imaging findings with different modalities in 10 patients of IAA were retrospectively analyzed, and a comparison with each other was made.Results On plain film, it was difficult to diagnose IAA though some suggestive signs could be found. Conventional ascending aortography could confirm the diagnosis and make a classification of IAA, but it was an invasive technique and sometimes several procedures of catheterization might be needed. Cardiac sonography was good at revealing intracardiac malformations, but had limitation in demonstrating the abnormalities of descending aortic arch. Spiral CT angiography (SCTA) could stereoscopically display the complicated anatomic relationship and the malformation in descending aortic arch, but it was helpless in finding intracardiac abnormalities. Electron beam CT (EBCT) was superior to SCTA in evaluating aortic arch, but it was not yet commonly used. MRI was another choice in diagnosing IAA. Conclusion Sonography, combined with SCTA, or EBCT, or MRI, is the most effective diagnostic method for IAA.