64层螺旋CT血管成像在主动脉夹层术前的评价与应用  

The Evaluation and Application of 64-slice Spiral CT Angiography before Operative Therapy of Aortic Dissection

作　　者：张蕴[1] 赵婷婷[1] 荐志洁[1] 李晨霞[1] 刘亚民[2] 田红燕[2] 白晓军[3] 许锁春[4] 

机构地区：[1]西安交通大学医学院第一附属医院医学影像科,陕西西安710061 [2]西安交通大学医学院第一附属医院周围血管科,陕西西安710061 [3]西安交通大学医学院第一附属医院心内科,陕西西安710061 [4]西安交通大学医学院第一附属医院心外科,陕西西安710061

出　　处：《实用放射学杂志》2009年第7期1024-1028,共5页Journal of Practical Radiology

摘　　要：目的评价64层螺旋CT血管造影（64-slice spiral CT angiography，64-SCTA）在主动脉夹层术前的应用价值。方法回顾性分析63例主动脉夹层的64-SCTA征象，并与数字减影血管造影（digital subtraction angiography，DSA）结果进行了比较。结果De Bakey Ⅰ型8例，De Bakey Ⅱ型2例，De Bakey Ⅲ型45例，主动脉壁内血肿8例。主动脉腔内见线状低密度内膜瓣影55例，将主动脉分成真假两腔，64-SCTA显示破入口位于升主动脉10例，距动脉瓣平均（5．65±2．93）cm，位于弓降部左锁骨下动脉开口以远44例，瘤颈长度平均（2．69±2．03）cm；瘤颈直径平均（2．86±6．06）cm。64-SCTA精确显示夹层破入口25例，DSA精确显示19例，两者有明显差异（P〈0．05）。结论64-SCTA在主动脉夹层术前有很高的应用价值，不但能明确诊断，还可为治疗方法的选择提供可靠依据，应作为首选检查方法。Objective To evaluate the value of 64-slice spiral CT angiography （64-SCTA） before operative therapy of aortic dissection（AD）. Methods CTA findings of AD were retrospectively analyzed and compared with the results of digital subtraction angiography （DSA）. Results De Bakey Type Ⅰ in 8 cases, De Bakey Type Ⅱ in 2 cases, De Bakey Type Ⅲ in 45 cases. Aortic intramural hematoma was in 8 cases. The true lumen and false lumen were detected in 55 cases. The average distance from aortic valve to the entry of aortic dissection was （ 5.65±2.93 ） cm in 10 cases . The average distance from left subclavical artery to the entry was （ 2.69± 2.03 ） cm in 44 cases, the average diameter of the segment was （ 2.86 ± 6.06 ） cm. 64- SCTA showed accurate position of the entry in 25 cases. DSA showed accurate position of the entry in 19 cases. There was significantly different （P〈0.05） for the accurate position of the entry. Conclusion 64-SCTA is of high value to the diagnosis of aortic dissection, especially preoperative evaluation. It can be used a first choice imaging method.

关 键 词：主动脉 夹层 血管造影术 体层摄影术 X线计算机 

分 类 号：R543.1[医药卫生—心血管疾病] R814.43[医药卫生—内科学]