主动脉壁内血肿的影像学诊断

Imaging Diagnosis of Aortic Intramural Hematoma

目的 分析总结主动脉壁内血肿 (AIH)的影像学特点。资料与方法 回顾 8例影像学资料完整的AIH病例 ,分析其胸部X线平片、CT、MRI及血管造影特点。结果 8例AIH ,1例累及升主动脉根部至腹主动脉远端 ,1例累及主动脉弓及降主动脉 ,6例累及降主动脉和 /或腹主动脉 ,其中 2例为降主动脉近中段动脉粥样硬化斑块穿通溃疡 (PAU)形成局部AIH。胸部X线平片、增强CT、MRI及血管造影均可见阳性征象 ,CT、MRI直接观察到病变程度及累及的范围。结论 CT和MRI是确诊AIH的最主要检查手段。

Objective To summarize the imaging features of aortic intramural hematoma (AIH).Materials and Methods During the period of Sep. 2001 to March 2003, eight patients with AIH were collected. The imaging findings, including plain chest film, CT, MRI and angiograph, were retrospectively analyzed. Results Of 8 patients, the lesion affected the root of ascending aorta up to the distal abdominal aorta (n=1), or the aortic arch and descending aorta (n=1), or the descending and/or abdominal aorta (n=6, of which AIH was caused by penetrating atherosclerotic ulcer at the mid segment of the descending aorta in 2). Positive imaging signs could be demonstrated on plain chest radiograph, enhanced CT, MRI and angiograph. CT and MRI could directly display the degree and extent of the lesion.Conclusion CT and MRI are the main means in confirming the diagnosis of AIH.