双源256层螺旋CT双能量扫描对主动脉壁间血肿的诊断价值

Clinical Value of Dual-source 256 Slice Spiral CT Dual-energy Scanning in Diagnosis of Aortic Intramural Hematoma

目的探讨双源256层螺旋CT双能量扫描对主动脉壁间血肿的诊断价值。方法回顾分析2012年10月至2014年8月期间主动脉壁间血肿CT影像检查资料。41例主动脉壁间血肿患者,均行双源256层螺旋CT双能量直接增强扫描诊断,并对原始数据进行图像后处理,包括虚拟平扫、多平面重建、曲面重建、最大密度投影等。结果主动脉壁间血肿致主动脉壁增厚,增厚主动脉壁均大于5 mm,其中新月形增厚39例,环形增厚2例。30例主动脉壁可见钙化斑块,25例可见钙化内膜内移,32例可见主动脉壁溃疡龛影,3例见内膜渗漏,无1例见内膜撕裂破口。合并单纯胸腔积液8例,胸腔积液并心包积液2例。结论双源256层螺旋CT双能量扫描能快速、准确、无创地诊断主动脉壁间血肿,可为临床制定合理治疗方案提供重要的信息。

Aim To investigate the value of dual-source 256 slice spiral CT dual-energy scanning in diagnosis of aortic intramural hematoma( AIH). Methods AIH CT imaging data were retrospectively reviewed from Oct 2012 to Aug 2014. 41 patients with AIH were diagnosed by dual-source 256 slice spiral CT dual-energy scanning. The original data were processed by image postprocessing technology,including virtual non-contrast( VNC),multi-planar reconstruction( MPR),curved planar reconstruction( CPR),and maximum intensity projection( MIP). Results AIH caused aortic wall thickening,and all thicken aorta walls were more than 5 mm. There were 39 cases of crescent-thicken and 2 cases of circular-thicken. The aortic wall calcified plaque could be seen in 30 cases of patients,and within-shifted calcified plaque could be seen in 25 cases of patients. There were 32 cases with ulcer niche and 3 cases with lining leakage in the aortic wall. But no intimal tear crevasse could be found in all patients. In addition,there were 8 cases with simple pleural effusion,and 2 cases with pleural effusion and pericardial effusion. Conclusions AIH can be diagnosed fast,accurately,and noninvasively by dual-source 256 slice spiral CT dual-energy scanning. Dual-source 256 slice spiral CT dual-energy scanning can provide important information for constituting clinical reasonable treatment scheme.