多层螺旋CT对主动脉夹层的诊断价值分析

Diagnostic value of multi-slice spiral CT in aortic dissection

目的 分析多层螺旋CT对主动脉夹层的诊断价值。方法 选取2012年1月-2014年1月在我院住院治疗的主动脉夹层患者36例。受检者均行多层螺旋CT检查,并签署知情同意书。结果 主动脉夹层分型主要分两种：De Bakey分型：Ⅰ型10例,Ⅱ型2例,Ⅲ型24例;Stanford分型：A型14例,B型22例。真假腔及累及分支：MSCT检查显示病变真腔、假腔及内膜片,多数假腔内为低密度血栓影,假腔密度先低于真腔密度后高于真腔密度,且假腔大、真腔小,有分离、内移的主动脉内膜瓣影,内膜撕裂26例。其中10例真腔小而假腔大,真腔明显受压变窄,SSD可见真假腔表面欠光滑,不能显示假腔周围的血栓。累及左锁骨下动脉、双肾动脉及腹腔动脉各7例;伴有左侧胸腔积液8例;右位主动脉弓5例。结论多层螺旋CT扫描速度快、分辨率高、无创伤、图像后处理成像能全面观察主动脉的情况,可显示内膜钙化内移、撕裂的内膜瓣片及真假两腔以及其与周围结构的关系,有利于AD治疗方案的制定。

Objetive To analyze the value of multi-slice spiral CT in diagnosis aortic dissection. Methods From January 2012 to January 2014, 36 patients with aortic dissection in our hospital were selected, and signed a multi layer spiral CT examination, and signed the informed consent. Results Types of aortic dissection： types were divided into two types： De Bakey type：10 cases of type Ⅰ, 2 cases of type Ⅱ, 24 cases of type Ⅲ;Types of Stanford：14 cases of type A, 22 cases of type B. The true and false lumen, and involving the branch： MSTC displayed the lesions of the true lumen and false lumen and intimal flap, most false lumen had low-density thrombus image, false lumen were lower density image at first than true lumen density and then were higher than the true lumen density, and false lumen was big,really cavity was small and had isolated, shift the aortic intimal flap shadow, intimal tear in 26 cases. 10 cases were small in true lumen but the false lumen was large, the true lumen significantly compressed, SDS showed the true false lumen surface was not smooth, and can not show the blood pressure of the false lumen. 7 cases involved left clavicle,double renal artery and celiac artery, 8 cases with left pleural effusion and 5 cases with right aortic arch. Conclusion Multilayer spiral CT sweep scanning speed is fast, resolution ratio is high, no trauma, image at the reason to like to fully observe the main pulse condition, can display the calcium endometrial shift, tearing the intimal flap and true and false lumen, and with the surrounding structure, is conducive to the development of AD treatment program.