胸主动脉术后假性动脉瘤的CT血管造影评价

Computed Tomography Angiography in Evaluating Postoperative Pseudoaneurysm of Phoracic Aorta

目的胸主动脉术后假性动脉瘤是非常危险的并发症,本研究应用CT血管造影(CTA)评价胸主动脉术后假性动脉瘤的特征。资料与方法回顾性分析2008年3月-2014年2月1836例胸主动脉术后患者的CTA随访资料,16例发生主动脉假性动脉瘤,分析其临床资料、CTA特征及随访结果。结果 16例患者假性动脉瘤位于升主动脉4例、弓部6例、降主动脉6例。升主动脉、主动脉弓、降主动脉瘤腔内血栓量及破口直径差异无统计学意义(P>0.05);升主动脉、主动脉弓、降主动脉瘤最大面积及动脉瘤发生时间差异有统计学意义(P<0.05)。结论胸主动脉手术后发生假性动脉瘤的患者可无症状,吻合口瘘和I型内漏是可能的主要原因,需定期复查及时诊断。

Purpose Postoperative pseudoaneurysm of phoracic aorta is a severe complication. The aim of this study is to evaluate the characteristics of thoracic aorta pseudoaneurysm using aortic CT angiography（CTA）. Materials and Methods 1836 thoracic aortic post operation patients from March 2008 to February 2014 were retrospectively studied. All follow-up patients underwent aortic CTA examination. Aortic pseudo-aneurysm was occurred in 16 cases. The clinical information and CTA characteristics of aortic pseudoaneurysm were analyzed. Results The locations of the aortic pseudoaneurysm were as followed： ascending aorta（4 cases）, aortic arch（6 cases）, and descending aorta（6 cases）. There was no significant difference of rupture diameter and thrombosis volume of pseudoaneurysm cavity in the ascending aorta, aortic arch and descending aorta（P〈0.05）. However, there was statistically significant difference of maximal pseudoaneurysm area and aneurysm occurred time in ascending aorta, aortic arch and descending aorta（P〈0.05）. Conclusion There are no symptoms of pseudo-aneurysm formation after thoracic aortic surgery. It is probably because of anastomotic fistula and I type endoleak. So it is important to early diagnose pseudoaneurysm formation after thoracic aortic surgery and periodic review.