CT血管成像在主动脉缩窄诊断与随访中的价值

The Value of Dual-source CT Angiography in the Diagnosis and Follow-up of the Aorta Coarctation

目的:评价CT血管成像(CTA)在主动脉缩窄的诊断与随访中的应用价值。方法:回顾性分析17例主动脉缩窄患者的CTA资料,其中6例有术后随访资料。通过多平面重组(MPR)、容积再现(VR)、最大密度投影(MIP)等多种图像后处理方法对其进行评价。结果:17例主动脉缩窄患者,男10例,女7例,其中导管旁型8例,导管前型4例,导管后型5例;5例行外科旁路搭桥手术,1例行血管置换手术,1例行球囊扩张手术;3例合并其他畸形,包括1例双上腔静脉,1例动脉导管未闭,1例肺静脉异位引流;17例患者可见不同程度的侧枝循环形成,支气管动脉、肋间动脉、胸廓内动脉增粗;5例手术患者旁路血管管腔通畅。结论:CT血管成像能很好地显示主动脉缩窄,对并发畸形、侧枝循环能良好显示,在术前评估、术后随访中起非常重要的作用。

Objective： To evaluate the value of CT angiography （CTA） in the diagnosis and follow-up of coarctation of the aorta. Methods： A retrospective analysis of 17 patients with coarctation of the aorta was performed, 6 patients underwent follow-up CT following bypass graft surgery. Results： Of 17 patients diagnosed as aortic coarctation, 10 patients were males, 7 were females. Eight cases were next to the ductus arteriosus, 4 cases before the catheter, 5 cases of in the catheter. Five patients underwent surgical bypass graft surgery, 1 case with vascular replacement surgery and 1 case with balloon angioplasty, 3 cases were associated with other malformations, including double superior vena cava （n=l）, patent ductus arteriosus （n= 1）, anomalous pulmonary venous drainage （n = 1）. Significant collateral vessels were observed in all patients, including the enlarged bronchial arteries, intercostals arteries and internal thoracic arteries. The bypasses of 5 operated-patients were patent. Conclusions： CTA can reliably diagnose aorta coarctation, show collateral vessels, and play a very important role in the postoperative follow-up.