BACKGROUND:Traumatic aortic dissection(TAD)has a low incidence but extremely high mortality.It always presents atypical clinical manifestations that are easily missed or misdiagnosed.This study mainly aims to describe...BACKGROUND:Traumatic aortic dissection(TAD)has a low incidence but extremely high mortality.It always presents atypical clinical manifestations that are easily missed or misdiagnosed.This study mainly aims to describe the imaging characteristics and management of TAD patients.METHODS:A retrospective analysis of 27 blunt TAD patients was performed between 2013 and 2020.Demographic features,imaging characteristics,and management were analyzed.RESULTS:Twenty-seven patients with type B aortic dissection(age 56.04±16.07 years,20 men)were included.Aortic intimal tears were mostly initiated from the aortic isthmus.The sizes of the proximal intimal tears in the greater curvature were larger than those in the lesser curvature(1.78±0.56 cm vs.1.24±0.52 cm,P=0.031).Compared with those in the control group,the maximum diameters of the aortic arch,thoracic aorta,and abdominal aorta in the TAD patients were all significantly widened(all P<0.050).Multivariate logistic regression analysis showed that the maximum diameter of the thoracic aorta was an independent risk factor for TAD,with a predictive value with an area under the receiver operating characteristic curve(AUC)of 0.673.Finally,26 patients successfully underwent delayed thoracic endovascular aortic repair(TEVAR),and the remaining one patient was treated conservatively.No progression of aortic dissection or death occurred during the six-month follow-up period.CONCLUSIONS:In blunt trauma,the aortic isthmus is the most common site of proximal intimal tears.An accurate diagnosis of TAD requires an overall consideration of medical history and imaging characteristics.Delayed TEVAR might be an eff ective therapeutic option for TAD.展开更多
目的:探讨常规MRI结合3D CE MRA对主动脉夹层动脉瘤的诊断价值。方法:回顾分析40例主动脉夹层病例,均行常规MRI和3D CE MRA检查。结果:40例主动脉夹层动脉瘤,DeBaKeyⅠ型7例,DeBaKeyⅡ型8例,DeBaKeyⅢ甲型2例,DeBaKeyⅢ乙型23例。本组4...目的:探讨常规MRI结合3D CE MRA对主动脉夹层动脉瘤的诊断价值。方法:回顾分析40例主动脉夹层病例,均行常规MRI和3D CE MRA检查。结果:40例主动脉夹层动脉瘤,DeBaKeyⅠ型7例,DeBaKeyⅡ型8例,DeBaKeyⅢ甲型2例,DeBaKeyⅢ乙型23例。本组40例均显示双腔征及内膜片,25例显示破口,13例假腔内血栓形成,16例伴少量胸腔积液。结论:常规MRI结合3D CE MRA对主动脉夹层动脉瘤的显示具有一定的敏感性和特异性,对主动脉夹层动脉瘤的诊断有重要价值。展开更多
基金This study was supported by the National Natural Science Foundation of China(81272075 and 81801572)the Foundation of Key Discipline Construction of Zhejiang Province for Traditional Chinese Medicine(2017-XK-A36).
文摘BACKGROUND:Traumatic aortic dissection(TAD)has a low incidence but extremely high mortality.It always presents atypical clinical manifestations that are easily missed or misdiagnosed.This study mainly aims to describe the imaging characteristics and management of TAD patients.METHODS:A retrospective analysis of 27 blunt TAD patients was performed between 2013 and 2020.Demographic features,imaging characteristics,and management were analyzed.RESULTS:Twenty-seven patients with type B aortic dissection(age 56.04±16.07 years,20 men)were included.Aortic intimal tears were mostly initiated from the aortic isthmus.The sizes of the proximal intimal tears in the greater curvature were larger than those in the lesser curvature(1.78±0.56 cm vs.1.24±0.52 cm,P=0.031).Compared with those in the control group,the maximum diameters of the aortic arch,thoracic aorta,and abdominal aorta in the TAD patients were all significantly widened(all P<0.050).Multivariate logistic regression analysis showed that the maximum diameter of the thoracic aorta was an independent risk factor for TAD,with a predictive value with an area under the receiver operating characteristic curve(AUC)of 0.673.Finally,26 patients successfully underwent delayed thoracic endovascular aortic repair(TEVAR),and the remaining one patient was treated conservatively.No progression of aortic dissection or death occurred during the six-month follow-up period.CONCLUSIONS:In blunt trauma,the aortic isthmus is the most common site of proximal intimal tears.An accurate diagnosis of TAD requires an overall consideration of medical history and imaging characteristics.Delayed TEVAR might be an eff ective therapeutic option for TAD.
文摘目的:探讨常规MRI结合3D CE MRA对主动脉夹层动脉瘤的诊断价值。方法:回顾分析40例主动脉夹层病例,均行常规MRI和3D CE MRA检查。结果:40例主动脉夹层动脉瘤,DeBaKeyⅠ型7例,DeBaKeyⅡ型8例,DeBaKeyⅢ甲型2例,DeBaKeyⅢ乙型23例。本组40例均显示双腔征及内膜片,25例显示破口,13例假腔内血栓形成,16例伴少量胸腔积液。结论:常规MRI结合3D CE MRA对主动脉夹层动脉瘤的显示具有一定的敏感性和特异性,对主动脉夹层动脉瘤的诊断有重要价值。
