多层螺旋CT在诊断主动脉夹层中的价值(1)
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2010年7月5日
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[摘要] 目的:回顾性分析主动脉夹层(aortic dissection,AD)的多层螺旋CT造影结果,然后通过正确率来探讨螺旋CT诊断AD的价值。方法:50例AD患者全部行平扫及增强扫描,并结合多平面重组、曲面重组等方法来显示AD及穿透溃疡,根据Stanford分类法分型。结果:对50例AD患者造影结果进行分析,分为A型27例,B型23例,所有患者均显示主动脉夹层典型征象;主要CT表现为主动脉壁呈新月型或环形增厚,无内膜破裂形成的双腔主动脉征象,增强扫描假腔无强化;内膜钙化向内移位14例;穿透性溃疡征6例;并发心包、纵隔及胸腔积液和积血共30例。结论:螺旋CT能够清楚显示夹层的部位、范围及并发症,可作为主动脉夹层的首选检查及随访方法。
[关键词] 多层螺旋CT;主动脉夹层;诊断价值
[中图分类号] R543 [文献标识码]C [文章编号]1674-4721(2010)07(a)-106-02
The value ofthe spiral CT in the diagnosis of aortic dissection
TANG Xiaoming
(Radiology Department of Radiology of Yongzhou City People's Hospital in Hunan Province,Yongzhou 425000,China)
[Abstract] Objective: A retrospective analysis of aortic dissection(aortic dissection,AD) of multi-slice CT angiography,and then the correct rate of the value of helical CT diagnosis of AD. Methods: 50 cases of AD patients had all been plain and enhanced scan,combined with MPR,surface restructuring and other methods to display AD and penetrating ulcer,according to stanford classification type. Results: 50 cases of AD patients to analyze the imaging results of 27 cases were divided into type A,B 23 cases,all cases were show typical signs of aortic dissection;the main CT showed aortic wall showed crescent or circular thickening,without the formation of double-lumen aortic intima rupture signs of enhanced scan false lumen no enhancement;inward displacement of intimal calcification 14 cases,6 cases of penetrating ulcer signs,concurrent pericardial,mediastinal,and pleural effusion and blood were positive in 20 cases,through conservative treatment,12 cases of complete absorption,six cases of some non-typical absorption,no significant changes in 4 cases. Conclusion: Spiral CT can clearly show dissection of the location,extent and complications of aortic dissection as the preferred method of inspection and follow-up.
[Key words] Multi-slice CT;Aortic dissection;Diagnostic value
主动脉夹层(aorticdissection,AD)是一种严重影响人类健康的主动脉疾患,在我国其发病率有明显上升的趋势,早期正确诊断是良好预后的关键,螺旋CT血管造影为非创性血管成像技术,它在大血管病变的诊断、治疗方案的拟定及术后的疗效评价方面有重要的临床应用价值,多层螺旋CT(multislicespiralCT,MSCT )由于扫描速度快,覆盖范围广,短时屏气即可完成主动脉全程的扫描,加上强大的图像后处理功能,非常适宜于主动脉病变的检查[1]。笔者收集了经16层螺旋CT检查诊断的AD患者50例,旨在探讨多层螺旋 CT 在AD诊断中的临床应用价值,现报道如下:
1 资料与方法
1.1 一般资料
回顾2007年3月～2009年3月本院收治的主动脉夹层患者的临床 MSCT资料50例,其中,男35例,女15例,年龄35～75岁,平均55 ......
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