主动脉夹层的MRI与综合超声诊断对照研究  

Aortic dissection: comparison of MRI and combined echocardiography

作　　者：王照谦[1,2,3] 刘玉清[1,2,3] 张挽时[1,2,3] 袁定华[1,2,3] 刘汉英[1,2,3] 荆宝莲[1,2,3] 

机构地区：[1]中国医学科学院中国协和医科大学北京阜外心血管病医院放射科 [2]大连医科大学附属第一医院放射科 [3]北京空军总医院磁共振室

出　　处：《中华放射学杂志》1997年第8期532-535,共4页Chinese Journal of Radiology

摘　　要：目的：比较ＭＲＩ与综合超声，即经胸超声（ＴＴＥ）和经食管超声（ＴＥＥ）在主动脉夹层（ＡＤ）诊断中的价值，探讨ＡＤ影像学综合诊断及其优选应用问题。材料与方法：分析２４例ＡＤ的ＭＲＩ与综合超声所见，并采用双盲法对两种技术进行对比研究。结果：ＭＲＩ和ＴＥＥ分别有１例假阴性和假阳性诊断。ＭＲＩ、ＴＥＥ和ＴＴＥ对ＡＤ诊断的敏感性分别为９６％、１００％和８３％，特异性分别为１００％、９７％和９３％。ＴＴＥ对内膜破口和假腔内血栓的检出率较低。ＭＲＩ和ＴＥＥ对内膜破口和假腔内血栓的显示各有其相对的优点，ＭＲＩ对主动脉弓分支血管近段及其与真假腔关系的观察优于ＴＥＥ。结论：ＭＲＩ和综合超声均是诊断ＡＤ的优良方法。对病情稳定的病例，尤其Ⅲ型ＡＤ，ＭＲＩ或综合超声均可为首选方法；对病情不稳定的病例，尤其Ⅰ型和Ⅱ型ＡＤ，综合超声应为首选方法。Purpose: To evaluate the usefulness and limitation of MRI and combined echocardiography [transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE)] in the diagnosis of aortic dissection(AD). Materials and methods: Twenty four patients with AD underwent MRI and combined TTE and TEE studies. The results were compared by independent double blind reading. Results: A false negative and a false positive diagnosis of AD was found in MRI and TEE study respectively, the sensitivity of MRI, TEE and TTE in the diagnosis of AD was 96%, 100% and 83%, and the specificity was 100%, 97% and 93% respectively. TTE was only of limited value in demonstrating entry tear and mural thrombus within the false lumen. In detecting the entry tear and mural thrombus within the false lumen, both MRI and TEE had their relative merits, and MRI was superior to TEE in showing proximal segments of arch vessels and their relationship to AD. Conclusion: Both MRI and combined echocardiography are invaluable methods in the diagnosis of AD. For patients with AD in stable clinical condition, particularly AD of type Ⅲ, MRI or combined echocardiography is the method of choice; and for patients in unstable condition, particularly AD of type Ⅰ and Ⅱ, combined echocardiography is preferable.

关 键 词：NMR 成像 主动脉夹层 超声波诊断 

分 类 号：R543.160.4[医药卫生—心血管疾病]