256排CT血管成像联合三维重建技术在主动脉夹层诊断及介入术前评估中的价值

The Value of 256-Row CT Angiography Combined with 3D Reconstruction in the Diagnosis of Aortic Coarctation and Pre-interventional Evaluation

目的:探讨256排CT血管成像联合三维重建技术在主动脉夹层(AD)诊断及介入术前评估中的价值。方法:回顾性收集分析2016年1月至2021年1月34例疑似主动脉夹层患者的影像资料,所有患者均行CTA及DSA检查,以DSA为“金标准”,计算CTA诊断AD患者破口位置的敏感性、特异性及准确性,并应用Kappa检验评估CTA对AD患者进行Debakey分型的一致性。结果:CTA共诊断出AD 30例(96.77%),CTA均能很好地显示了AD的破口位置、累及范围、内膜片、真假腔及夹层旋转方向;以DSA为“金标准”,CTA诊断AD患者破口位置的敏感性为93.55%,特异性为66.67%及准确率为91.18%。对30例AD患者进行Debakey分型,其中Ⅰ型9例,Ⅱ型7例,Ⅲ型14例,CTA对AD患者分型的一致性均较好,Kappa值分别为0.813、0.792、0.802。结论:256排CT血管成像联合三维重建技术对AD的具有较高的诊断效能,能够准确地显示AD破口位置并准确分型,为介入手术方案制定提供了重要的参考依据。

Objective:Exploring the value of 256-Row CT angiography combined with 3D reconstruction technology in the diagnosis of aortic dissection(AD)and pre-interventional evaluation.Methods:We retrospectively collcted and analyzed the imaging data of 34 patients with aortic coaretation from January 2016 to January 2021,all patients underwent CTA and DSA,and DSA was used as the“gold standard”to calculate the sensitivity,specificity and accuracy of CTA in diagnosing the location of the rupture in AD patients,and the Kappa test was applied to assess CTA was used to assess the consistency of Debakeys staging of AD patients.Results:A total of 30 cases(96.77%)of AD were diagnosed by CTA,and the CTA could well show the location of the rupture,the extent of involvement,the endothelial piece,the true and false lumen and the direetion of rotation of the entrapment in AD;using DSA as the“gold standard”,the sensitivity of CTA in diagnosing the location of the rupture in AD patients was 93.55%,the specificity was 66.67%and the accuracy was 91.18%.The sensitivity of CTA in diagnosing the location of rupture in AD patients was 93.55%,the specifecity was 66.67%and the accuracy was 91.18%.Debakey typing was performed in 34 AD patients,including8 cases of typeⅠ,2 cases of typeⅡand 24 cases of typeⅢ.The consistency of CTA in the typing of AD patients was good,with happa values of 0.813,0.792 and 0.802,respectively.Conclusion:256-Row CT angiography combined with 3D reconstruction technology has high diagnostic eficacy for AD,and can accurately show the location of AD rupture and accurate staging,which provides an important reference basis for interventional procedure planning.