CT血管成像与超声造影在DeBakeyⅢ型主动脉夹层介入术后随访中的应用

Application of CT Angiography and Contrastenhanced Ultrasound in Follow-up of Patients with Debakey Type Ⅲ Aortic Dissection After Intervention Operation

目的探讨CT血管成像(CTA)与超声造影(CEUS)在DeBakeyⅢ型主动脉夹层(AD)介入术后随访中的应用价值。方法回顾性分析我院53例DeBakeyⅢ型AD患者的临床资料,行AD介入术,术后随访3个月,均行CEUS和CTA检查,比较两种方法检测的破口数量及腹段真假腔直径。结果术后3个月,12例Ⅲa型AD患者经CEUS和CTA检查,A、B、C检测段内均无新发内膜撕裂或夹层;另41例Ⅲb型AD患者,CTA检查共发现破口128个,平均(3.12±0.91)个;CEUS检查共发现破口73个,平均(1.78±0.56)个;两者平均腹段主动脉破口检出个数比较,差异有统计学意义(P<0.05);CEUS检查41例Ⅲb型AD患者破口数量,A检测段平均0.27个,B检测段平均0.98个,C检测段平均0.54个;CTA检查,A检测段平均0.95个,B检测段平均1.49个,C检测段平均0.68个;两种检查方法A、B、C检测段平均破口检出数量比较,差异均有统计学意义(P<0.05);CEUS与CTA检测41例Ⅲb型AD患者腹腔干、肾动脉、肠系膜及腹主动脉分叉水平真假腔直径比较,差异均无统计学意义(P>0.05)。结论CTA和CEUS在DeBakeyⅢ型AD患者预后评估中具有重要作用,两者各有优缺点。

Objective To explore the application value of CT angiography (CTA) and contrast-enhanced ultrasound (CEUS) in the follow-up of patients with DeBakey type Ⅲ aortic dissection (AD) after intervention operation.Methods The clinical data of 53 cases of patients with DeBakey type Ⅲ AD in our hospital were retrospectively analyzed. They were given AD intervention.All patients were given CEUS and CTA at 3-month follow-up after operation.The number of crevasses and the diameter of true and false abdominal cavity were compared between the two methods.Results At 3 months after operation,there were no new intimal tears or dissections in the test segments A,B and C among 12 patients with type Ⅲa AD examined by CEUS and CTA.Another 41 patients with type Ⅲb AD were found 128 crevasses with an average of (3.12±0.91) by CTA. A total of 73 crevasses were found by CEUS with an average of (1.78±0.56).There was statistically significant difference in the average detected number of abdominal aortic crevasses between the two groups (P<0.05).There were average 0.27 in A test segment, average 0.98 in B test segment and average 0.54 in C test segment in the crevasses quantity among 41 patients with type Ⅲb AD by CEUS.There were average 0.95 in A test segment,average 1.49 in B test segment and average 0.68 in C test segment by CTA. There was statistically significant difference in the average detected number of crevasses in the test segments A,B and C between the two methods (P<0.05).There was no significant difference in the diameters of true and false cavity in celiac trunk,renal artery, mesentery and abdominal aortic bifurcation of 41 patients with type Ⅲb AD by CEUS and CTA (P>0.05).Conclusion CTA and CEUS play an important role in the prognosis evaluation of patients with DeBakey type Ⅲ AD.Both have their own advantages and disadvantages.