64排CTA与超声心动图在诊断主动脉夹层中的应用

Application of 64-slice CTA and Ultrasonic Cardiogram in the Diagnosis of Aortic Dissection

目的探讨64排CT血管成像(CTA)与超声心电动图在主动脉夹层的应用及诊断价值。方法选择2015年3月-2018年3月在我院确诊为主动脉夹层患者57例进行回顾性分析,所有患者均使用64排CTA、超声心动图检查,观察两种诊断方式诊断异常结果(总体异常、主动脉弓部异常、主动脉瓣膜异常、胸及腹主动脉异常、冠状动脉异常)、DeBakey分型(Ⅰ型、Ⅱ型、Ⅲ型)及Stanford分型(A型、B型)的诊断情况。结果 64排CTA、超声心电动图对总体异常、主动脉瓣膜异常检出率,差异无统计学意义(P>0.05);超声心电动图对主动脉弓部异常检出率高于64排CTA(P<0.05),64排CTA冠状对动脉异常、胸及腹主动脉异常检出率高于超声心电动图(P<0.05)。64排CTA、超声心电动图对DeBakeyⅠ型、DeBakeyⅡ型、Stanford A型检出率,差异无统计学意义(P>0.05);64排CTA冠状对DeBakeyⅢ型、Stanford B型检出率高于超声心电动图(P<0.05)。结论两种诊断方式的临床诊断均存在各自缺陷,但64排CTA与超声心动图比较诊断优势明显,临床使用价值相对较高。

Objective To explore the application and diagnostic value of 64-slice CT angiography(CTA)and ultrasonic cardiogram in the diagnosis of aortic dissection.Methods A total of 57 cases of aortic dissection diagnosed in our hospital from March 2015 to March 2018 were analyzed retrospectively.All patients were given 64-slice CTA and ultrasonic cardiogram to observe the abnormal diagnostic results of the two diagnostic methods(overall abnormalities,aortic arch abnormalities,aortic valve abnormalities,thoracic and abdominal aortic abnormalities,coronary artery abnormalities),DeBakey classification(typeⅠ,typeⅡ,typeⅢ)and Stanford classification(type A,type B).Results There were no significant differences in the overall abnormalities and aortic valve abnormalities between 64-slice CTA and ultrasonic cardiogram(P >0.05).The detection rate of abnormal aortic arch of ultrasonic cardiogram was higher than that of 64-slice CTA(P<0.05),and the detection rates of coronary artery abnormalities,thoracic and abdominal aortic abnormalities of 64-slice CTA were higher than those of ultrasonic cardiogram(P<0.05).There were no significant differences in the detection rates of DeBakey typeⅠ,DeBakey typeⅡand Stanford type A between 64-slice CTA and ultrasonic cardiogram(P >0.05).The detection rates of DeBakey typeⅢand Stanford type B of 64-slice CTA were higher than those of ultrasonic cardiogram(P<0.05).Conclusion There are certain defects in the clinical diagnosis of the two diagnostic methods,but the 64-slice CTA has obvious advantages than ultrasonic cardiogram,and it has relatively high clinical application value.