CT增强血管造影对孤立性内脏动脉夹层的诊断及治疗价值

The value of enhanced computed tomography angiography in the diagnosis and treatment decision of isolated dissection of the visceral arteries

目的 探讨CT增强血管造影对孤立性内脏动脉夹层的临床诊断及治疗价值.方法 回顾性分析2012年至2015年中山大学附属第一医院放射科增强CT诊断的孤立性内脏动脉夹层患者的临床及影像资料,对肠系膜上动脉夹层的CT血管造影征象与临床症状及治疗选择的相关性进行研究.结果 51例患者的56例内脏动脉夹层,包括49例肠系膜上动脉夹层,4例髂动脉夹层,2例肾动脉夹层,1例腹腔干夹层.内脏动脉夹层长度(53.3±32.1)mm,真腔直径(3.4±1.7)mm,真腔残留率(40.9±11.3)%.51例患者中,1例外科治疗,8例血管内介入治疗,42例保守治疗.结论 增强CT血管造影可作为发现孤立性内脏动脉夹层、评价治疗效果及追踪复查的有效方法.

Objective To study the value of enhanced computed tomography (CT) angiography in the diagnosis and treatment decision of isolated dissection of the visceral arteries. Methods Retrospectively evaluated the clinical report and CT imaging of isolated dissection of the visceral arteries from 2012 to 2015. Studied the relationship of CT features with clinical symptom, treatment strategy in superior mesenteric artery. Results Fifty-six isolated dissections of the visceral artery were found in 51 patients, including 49 superior mesenteric artery dissections,4 iliac artery dissections,2 renal artery dissections and 1 celiac artery dissection. The length of visceral artery dissection was(53.3±32.1)mm,true lumen diameter was(3.4±1.7)mm,true lumen residual diameter was (40.9±11.3)%. In 51 patients, one achieved surgery, 8 achieved endovascular treatment and 42 were treated conservatively. Conclusion Enhanced CT angiography is an effective method in detecting isolated dissection of the visceral arteries, and plays an important role in therapy evaluation and follow-up.