摘要
目的 :探讨多层螺旋CT(mutislice CT,MSCT)在急性主动脉综合征诊断中的应用价值。方法 :对56例急性胸痛或背痛、临床怀疑主动脉夹层等急性主动脉综合征病变的患者行CT增强扫描,并在后处理工作站重建主动脉的三维血管图像,分析其CT影像征象。结果:所有病例均经手术或血管造影确诊,其中主动脉夹层39例(Stanford A型14例,B型25例,同时合并升主动脉瘤2例,腹主动脉瘤1例),MSCT上均可见主动脉呈双腔样改变及低密度撕裂内膜片影;主动脉壁间血肿10例,MSCT重建图像见主动脉腔内新月形或环形无强化高密度影;穿透性粥样硬化性溃疡7例(4例合并壁间血肿),MSCT显示主动脉管壁内造影剂充盈的"龛影"。结论:MSCT作为快速、无创的影像学检查,客观地显示主动脉夹层、主动脉壁间血肿、穿透性粥样硬化性溃疡的直接和间接影像征象,对急性主动脉综合征的诊断及鉴别诊断具有重要价值。
Objective To evaluate the value of multi-slice spiral CT for diagnosing acute aortic syndrome（AAS）. Methods Totally 56 patients suffering from acute chest or back pain, suspected with acute aortic syndrome such as aortic dissection（AD）, underwent CT contrast-enhanced scanning, Three-dimensional vascular images of the aorta were reconstructed with post-procession workstation, and the CT imaging features were analyzed. Results The diagnosis was confirmed by operation or angiography in all cases, and there were AD in 39 cases including 14 cases of Stanford A aortic dissection and 25 cases of Stanford B aortic dissection, of which, there were 2 cases of AD combined with ascending aortic aneurysm and 1case of AD combined with abdominal aortic aneurysm. MSCTA displayed double lumen sign and low density avulsion intimal flap in the aorta. Intramural hematoma（IMH） were showed in 10 cases, with crescent or circular shaped non-enhanced high density shadows found by MSCT reconstruction in the aortic lumen. Penetrating atherosclerotic ulcers（PAU）were found in 7 cases including 4 cases accompanied by intramural hematoma, who had ＂niche＂ filling with contrast medium in aortic wall found by MSCT. Conclusion MSCT can display of direct and indirect imaging signs of AD, IMH and PAU, and thus can be used for the rapid and non-invasive diagnosis and differential diagnosis of AAS.
出处
《医疗卫生装备》
CAS
2015年第7期85-87,共3页
Chinese Medical Equipment Journal
