CT在主动脉瘤中的诊断价值

Diagnostic value of CT in patients with aortic aneurysm

目的探讨CT在主动脉瘤中的诊断价值。方法收集行CT扫描的主动脉瘤患者95例,所有患者均未行手术治疗。收集患者基线资料及分析CT相关资料,如区分真性动脉瘤、假性动脉瘤,主动脉瘤部位,CT测量相关指标,主动脉瘤附壁血栓情况等。图像均由两名影像诊断医师行单独分析,若有不同意见则行讨论而达成一致。结果本组中真性动脉瘤82例,假性动脉瘤13例。瘤体形态以囊状动脉瘤常见(50.5%),其次为混合型动脉瘤(25.3%)及梭型动脉瘤(24.2%)。瘤体内可见钙化者为61.1%,溃疡者为55.8%。累及范围为(104.3±71.0)mm,瘤径长度(0~30)mm,瘤体直径(53.2±16.9)mm。95例患者中,56例(58.9%)患者伴有附壁血栓形成。血栓形态依次为弧形(46.4%)、不规则型(26.8%)、环形(16.1%)、双凹形(10.7%)。血栓位置依次为前壁(33.9%)、左侧壁(26.8%)、右侧壁(19.6%)、后壁(14.3%)、双侧壁(5.4%)。血栓厚度为7.7(0~18.0)mm,血栓长度35(0~87.0)mm。结论 CT在主动脉瘤的诊断中不仅能够获取瘤体本身相关改变特征,更能发现附壁血栓形成情况,对临床风险评估及指导手术治疗有重要意义。

Objective To assess the diagnostic value of CT in patients with aortic aneurysm.Methods We retrospectively enrolled 95 patients with aortic aneurysm who underwent CT and had treatment without surgery.All patients were analyzed by two radiologist,respectively.In case of disagreement,a joint reading session was performed to reach a consensus decision.The parameters were as follows:real aneurysm or false aneurysm;shape,type,extension of the aortic aneurysm and intraluminal thrombus.Results Among the 95 aortic aneurysm patients,82 patients were real aneurysm and 13 patients were false aneurysm.The most frequency shape of the aortic aneurysm was follicle(50.5%),and followed by the mixed(25.3%)and fusiform(24.2%).Calcification was observed in 61.6%patients,while,ulcer was observed in 55.8%.The mean scope of aneurysm body was(104.3±71.0)mm,while the distal neck was 0(0~30)mm,the diameter of aneurysm body was(53.2±16.9)mm.Totally,mural thrombosis had been detected in 56(58.9%)patiens with AA.The form of the thrombosis was consist of arc(46.4%),inregular shape(26.8%),ring(16.1%),double concave(10.7%).The most position of the thrombosis was anterior wall(33.9%),followdn left lateral wall(26.8%),posterior wall(14.3%)and two-sided wall(5.4%).The thrombus thickness was 7.7(0~18.0)mm,and the thrombus length was 35(0~87.0)mm.Conclusion CT is the gold standard for AAA imaging due to its high resolution and excellent image quality,and is the suitable modality for assessing the aortic aneurysm in clinical diagnosis and properative evaluation.