摘要
目的:采用双源CT血管造影(CT angiography,CTA)对急性A型主动脉夹层(acute type A aortic dissection,ATAAD)患者进行术前评价头颈动脉扫描的可行性及对临床治疗的指导价值。方法 :连续收集243例临床拟诊为ATAAD患者,将其分成2组:实验组(120例)患者行头顶—盆腔CTA扫描;对照组(123例)患者行胸廓入口—盆腔CTA扫描。对实验组进行图像主观质量评分并分析与手术相关的头颈血管CTA征象。比较2组患者的辐射剂量、手术方式、脑保护方式及术后ICU时间、住院时间、术后神经系统并发症(neurologic dysfunction,ND)和全因死亡率。结果:实验组头颈部血管均满足诊断。13例患者术前依照CTA提供的头颈血管阳性特征由常规单侧脑保护改为双侧脑保护。实验组的辐射剂量、术后ND、ICU时间和住院时间均少于对照组,差异有统计学意义(P<0.05)。术后全因死亡率2组相比无统计学差异(P>0.05)。结论:采用CTA对ATAAD患者进行术前头颈血管扫描是可行的,头颈动脉CTA信息可为临床提供重要依据。
Objective To investigate the feasibility of combined CT angiography(CTA)of head,neck and aorta in acute type A aortic dissection(ATAAD)and whether the incremental craniocervical information benefits the surgeon and leads to improved clinical outcomes.Methods One hundred and twenty ATAAD patients in a CAC group underwent combined aortic CTA and 123 ATAAD patients in a control group underwent conventional aortic CTA.In the CAC group,the image quality was analyzed and critical CTA findings in craniocervical arteries were determined for further surgery procedure.The radiation dose,intraoperative cerebral protection method,and postoperative intensive care units(ICU)time,in-hospital time,neurologic dysfunction(ND)and all-cause mortality were compared between the two groups.Results The CAC group had all the carotid and cerebral arteries diagnosed successfully.There were 13 patients replaced conventional unilateral antegrade selective cerebral perfusion with bilateral one according to the head and neck CTA images in the CAC group.The CAC group had effective radiation dose,postoperative ND,ICU time and in-hospital time significantly lower than those of the control group(P<0.05).There were no statistical differences between the all-cause morbidities of the two groups(P>0.05).Conclusion A combined CTA of head,neck and aorta in ATAAD is feasible.The incremental craniocervical information may lead to improved clinical outcomes
作者
赵宏亮
王晋
郑敏文
石明国
宦怡
ZHAO Hong-liang;WANG Jin;ZHENG Min-wen;SHI Ming-guo;HUAN Yi(Radiology Department,the First Affiliated Hospital of the Fourth Military Medical University,Xi'an 710032,China;Radiation Medicine Research and Teaching Section,the Fourth Military Medical University,Xi'an 710032,China)
出处
《医疗卫生装备》
CAS
2018年第3期61-64,共4页
Chinese Medical Equipment Journal
