主动脉壁内血肿的MSCT影像学征象及诊断价值探讨

The Value of MSCT in the Diagnosis of Aortic Intramural Hematoma

目的：探讨主动脉壁内血肿（IMH）的MSCT影像学征象及诊断价值。方法：回顾性分析31例主动脉壁内血肿的MSCT图像,包括平扫图像及增强图像。结果：31例主动脉壁内血肿,15例为A型,16例为B型。MSCT主要表现为：1主动脉壁呈环形或新月形增厚,增厚血肿壁2.5~24mm不等,13例患者检出主动脉内壁溃疡;220例出现了心包积液和/或胸腔积液,12例显示出内膜钙化斑内移,31例均出现了延迟显像浆膜面强化。结论：MSCT平扫及增强检查可清楚显示血肿的部位、累及范围、血肿程度以及并发间接征象,可对主动脉壁内血肿进行明确诊断及鉴别诊断。

Purpose：To investigate the value of MSCT in the diagnosis of aortic intramural hematoma（AIH）.Methods：The routine CT and CT angiography findings of 31 cases with aortic intramural hematoma were retrospectively analyzed.Results：Fifteen cases were diagnosed as Stanford A AIH,while the other 16 cases were diagnosed as Stanford B AIH.The MSCT findings showed as follows：circular or crescentic thickening（2.5-24mm）;penetrate ulcer（13 cases）;pericardial effusion or/and pleural effusion（20 cases）;displaced intimal calcifications（12 cases）;delayed enhancement of aorta serous membrane（31 cases）.Conclusion：The location,extent,thickness and complications of aortic intramural hematoma can be clearly displayed by MSCT,thereby valuable information for diagnosis and differential diagnosis can be provided.