主动脉夹层多层螺旋CT诊断与DSA诊断的临床对比

Clinical comparison of multi-slice spiral CT and DSA in diagnosis of aortic dissection

目的:探究主动脉夹层多层螺旋CT与数字减影血管造影(DSA)诊断的临床价值。方法:选择疑似主动脉夹层患者40例,分别采取多层螺旋CT与DSA诊断。结果:40例患者中,被确诊为主动脉夹层36例;术后通过检查发现内膜瓣36例,破口数129个,受累分支数111条。多层螺旋CT组内膜瓣、真假腔检出率与DSA组比较,差异无统计学意义(P>0.05);多层螺旋CT组内膜破口、分支受累检出率与DSA组比较,差异有统计学意义(P<0.05)。多层螺旋CT与DSA对主动脉夹层第一破口大小、第一破口与左锁骨下动脉距离、真腔远端直径、左锁骨下动脉开口平面胸主动脉最大径测量值比较,差异无统计学意义(P>0.05)。结论:多层螺旋CT与DSA对主动脉夹层的诊断与金标准具有较高的一致性,但多层螺旋CT的应用范围更广,且安全性比较高。

Objective:To explore the clinical value of multi-slice spiral CT and DSA in diagnosis of aortic dissection.Methods:40 patients with suspected aortic dissection were selected and diagnosed with MSCT and DSA respectively.Results:Among 40 patients,36 were diagnosed as aortic dissection.After the operation,there were 36 cases with endometrial flap,129 breaks and 111 branches involved.There was no significant difference in detection rate of inner membrane flap and true and false cavity in multi-slice spiral CT group and DSA group(P>0.05).There was significant difference in detection rate of endometrial laceration and branch involvement in multi-slice spiral CT group and DSA group(P<0.05).There was no significant difference in size of the first breach of aortic dissection,the distance between the first breach and the left subclavian artery,diameter of the distal end of the true lumen,measurement of the maximum diameter of the thoracic aorta at the opening plane of the left subclavian artery in multi-slice spiral CT group and DSA group(P>0.05).Conclusion:The diagnosis of aortic dissection by multi-slice spiral CT and DSA is consistent with the gold standard,however,the application of multi-slice spiral CT is more extensive and its safety is higher.