MSCTA对主动脉夹层的诊断价值及其与DSA对比研究

Diagnostic Value of MSCTA for Aortic Dissection and Its Comparison with DSA

目的对比探讨多层螺旋CT血管成像(MSCTA)及数字减影血管造影(DSA)对主动脉夹层(AD)的临床诊断价值。方法回顾性分析我院2013年1月-2017年12月收治的50例AD患者的临床资料,所有患者均行MSCTA与DSA检查,将两种检查结果对比分析。结果 MSCTA诊断AD未见破口7例,1个破口35例,2个破口8例,检出率为86.00%;DSA诊断AD未见破口6例,1个破口37例,2个破口7例,检出率为88.00%。两者比较,差异无统计学意义(P>0.05);MSCTA共检出51个破口,其中≥15mm破口32个,<15mm破口19个;DSA检出51个破口,其中≥15mm破口34个,<15mm破口17个,两者比较,差异无显著性(P>0.05);MSCTA诊断AD显示破口平面主动脉直径为(29.68±6.33)mm,DSA诊断AD显示破口平面主动脉直径为(28.94±5.89)mm,两者比较,差异无统计学意义(P>0.05);MSCTA检查显示出现真假腔48例,内膜移位47例,分支受累8例;DSA检查显示出现真假腔45例,内膜移位45例,分支受累7例,两者比较,差异无显著性(P>0.05);MSCTA检查显示夹层假腔内血栓者36例,动脉壁钙化11例,而DSA则无法显示夹层血栓及动脉壁钙化的具体情况。结论 MSCTA诊断AD与金标准DSA具有较好的一致性,同时可显示夹层假腔内血栓及动脉壁钙化情况,有助于AD的早期诊断。

Objective To compare the clinical diagnostic value of multi-slice spiral CT angiography(MSCTA)and digital subtraction angiography(DSA)in aortic dissection(AD).Methods The clinical data of 50 patients with AD admitted to our hospital from January 2013 to December 2017 were analyzed retrospectively.All patients were given MSCTA and DSA,the examination results were compared and analyzed.Results There were 7 cases without crevasse,35 cases with 1 crevasse and 8 cases with 2 crevasses by MSCTA in the diagnosis of AD,and the detection rate was 86.00%.There were 6 cases without crevasse,37 cases with 1 crevasse and 7 cases with 2 crevasses by DAS in the diagnosis of DS,and the detection rate was 88.00%.There were no significant differences between the two methods(P>0.05).There were 51 crevasses were detected by MSCTA,including 32 crevasses≥15 mm and 19 crevasses<15 mm.51 crevasses were detected by DSA,including 34 cases of crevasses≥15 mm and 17 crevasses<15 mm,and there were no significant differences between the two(P>0.05).The MSCTA diagnosis of AD showed that the aorta diameter of crevasse surface was(29.68±6.33)mm,and the DSA diagnosis of AD showed the aorta diameter of crevasse surface was(28.94±5.89)mm(P>0.05).The MSCTA examination showed that there were 48 cases of true and false cavities,47 cases of endometrial displacement and 8 cases of branch involvement.DSA examination showed that there were 45 cases with true and false cavities,45 cases with endometrial displacement and 7 cases with branch involvement(P>0.05).MSCTA examination showed there were 36 cases of dissection pseudocavity thrombus and 11 cases of arterial calcification,and DSA examination didn’t not show the specifics of dissection thrombosis and arterial calcification.Conclusion MSCTA has a good consistency with gold standard DSA in the diagnosis of AD,and can show then of dissected pseudoluminal thrombosis and arterial wall calcification,which is helpful for the early diagnosis of AD.