摘要
目的：探讨多层螺旋CT血管成像（MSCTA）对孤立性肠系膜上动脉夹层（SISMAD）的诊断价值。方法：回顾分析我院自2008年1月-2012年1月间7例SISMAD病例的临床及影像资料，男6例、女1例，年龄43-61岁（平均53±6．6岁）。结果：根据Yun分型，I型1例，116例（Ⅱaml例、Ⅱb型5例）；7例全部清晰显示撕裂的内膜片及真假两腔；1例Ⅱa型初破口及1例I型再破口位于肠系膜上动脉（SMA）中段，余6例初破口均在近段（1．2-2．5cm）；SMA明显增粗3例，2例SMA近、中段周围脂肪间隙内有明显渗液，2例局部肠壁轻度水肿、肠腔积液；5例lib型SMA均有数支分支受累。6例SMA近、中段移行处存在急转，在（斜）矢状位MIP图像上SMA与腹主动脉呈“h”形。结论：MSCTA能明确SISMAD诊断，同时能显示病变细节及继发性病变；对临床及时选择治疗方案具有重要意义。
Purposes： To assess the value of the multi-slice CT angiography imaging （MSCTA） in the diagnosis of spontaneous isolated superior mesenteric artery dissection （SISMAD）. Methods： We retrospectively analyzed clinical presentation, imaging appearances of 7 patients who were diagnosed as SISMAD from January 2008 to January 2012 in our institution. And there were 6 males and 1 female with a mean age of 53±6.6 years （range, 43-61 years）. Results： According to Yun＇ s classification, SISMAD was categorized into the following three types based on their imaging appearances： 1 case was type I, 6 cases were typelI（1 lla,5 typellb）, and the intimal flap and the true and false lumen were showed clearly in 7 patients. The intimal entry located in the proximal SMA （froml.2 to 2.5 cm） was found in 6 cases, except for 1 entry and 1 re-entry located at the middle section of SMA. Other findings associated with SISMAD were enlarged diameter of the SMA （n=3）, increased attenuation of the fat around the proximal and the middle SMA （n=2）, and local wall thickening due to edema with bowel pitch effusion （n=2）. The sharp turn located in the junction of the proximal and the middle SMA was found in 6 cases, which was displayed the type ＂h＂ at the position of the （oblique） sagittal MIP images. Conclusion： MSCTA can be used to diagnose SISMAD clearly and definitely, and also disease details and secondary lesions can be shown. And it is very important for us to provide accurate information for the clinical treatment plans.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2013年第4期350-354,共5页
Chinese Computed Medical Imaging
基金
上海市科委生物医学重点项目(No 10411953200)~~
