双源CT血管成像对主动脉夹层的诊断价值

The diagnostic value of dual-source CT angiography in aortic dissection

目的探讨双源CT(DSCT)血管成像对主动脉夹层(AD)的诊断价值。方法回顾性分析吉林油田总医院2015年3月至2017年4月确诊的34例AD患者的临床资料,将CT扫描所得原始图像进行最大密度投影(MIP)、曲面重建(CPR)和容积再现(VR)重组,结合原始图像分析AD的DSCT血管成像特点。结果所选患者均被证实为AD,其中经手术证实21例,经DSA证实13例。34例患者DSCT血管成像对主动脉主干及其属支显示清晰,对真假腔及内膜片形态、范围的显示准确直观。DSCT血管成像诊断准确率为100.0%(34/34),其中包括Dabakey分型Ⅰ型15例(占44.1%),Ⅱ型11例(占32.4%),Ⅲ型8例(占23.5%)。结论相对其他影像检查方法,DSCT血管成像具有无创、快速、准确及图像直观等优点。结合MIP、CPR及VR等重组图像,可为临床诊断AD提供可靠的影像学支持。

Objective To explore the diagnostic value of dual-source CT（DSCT） angiography in aortic dissection（AD）. Methods Retrospective analysis in March 2015 to April 2017 confirmed the clinical data of 34 patients with AD, CT scanning the original image to maximum density projection（MIP）, curved surface reconstruction（CPR） and the volumetric representation（VR）, the original image analysis DSCT vascular imaging feature of AD. Results All the selected patients were confirmed as AD, including 21 cases confirmed by surgery and 13 cases confirmed by DSA. DSCT angiography showed clearly the main aorta and its branches in 34 patients, and showed accurately and intuitively themorphology and range of the true and false lumen and the inner diaphragm. DSCT vascular imaging diagnostic accuracy was 100.0%（34/34）, including Dabakey parting Ⅰ 15 cases（44.1%）, type Ⅱ 11 cases（32.4%）, Ⅲ type 8 cases（23.5%）. Conclusion Compared with other imaging methods, DSCT angiography has the advantages of noninvasive, rapid, accurate and intuitive images. Combined with recombinant images such as MIP, CPR and VR, it can provide reliable imaging support for clinical diagnosis of AD.