CT血管造影诊断B型主动脉夹层再破口  

Diagnosis of re-entry tears in type B aortic dissection with CT angiography

作　　者：禹纪红[1] 黄连军[2] 蒋世良[1] 金敬琳[1] 吕滨[1] 常宗平[1] 

机构地区：[1]北京协和医学院,中国医学科学院,阜外心血管病医院放射科,北京100037 [2]首都医科大学附属安贞医院放射科,北京100029

出　　处：《中国医学影像技术》2009年第12期2214-2217,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价CT血管造影(CTA)在诊断B型主动脉夹层(AD)再破口中的价值。方法分析110例典型B型AD患者的CTA增强扫描及其中70例主动脉数字剪影血管造影(DSA)检查的影像资料,分别统计夹层再破口的数量、位置、大小,对两种检查的结果采取Kappa一致性检验。结果83.64%B型AD患者具有多个再破口,人均再破口(3.41±1.90)个,以腹主动脉中段再破口的数量最多,大破口最常位于夹层最远端。70例CTA与主动脉DSA结果比较,CTA发现再破口的灵敏度为93.78%,特异度为88.89%,两种检查方法一致性检验的Kappa值为0.827(P<0.01)。结论CTA可清晰显示B型AD再破口的数量、位置及大小等特点,与DSA在显示B型AD再破口方面具有良好的一致性,可作为再破口观察和随访的主要方法。Objective To assess the value of CT angiography（CTA） in diagnosis of re-entry tears in type B aortic dissection.Methods One hundred and ten patients with typical type B aortic dissection were enrolled.Data derived from the CTA scans of all the patients and DSA of 70 patients were reviewed.The number,location and size of the re-entry tears were calculated and analyzed.CTA findings were compared with DSA results by using Kappa statistics.Results The mean number of re-entry tears was 3.41±1.90,and 83.64%（92/110） patients had multiple tears.Re-entry tears occurred in the middle of the abdominal aorta were more common than that in the other palce of aorta.The large ones commonly located in the most remote position of dissection.The sensitivity and specificity of finding re-entry tears with CTA was 93.78% and 88.89% respectively,the Kappa value was 0.827（P0.01）.Conclusion The consistency between CTA and DSA was good.The re-entry tears in type B aortic dissection can be depicted clearly with CTA,and CTA can be used as the main method for further observation and follow-up of this disease.

关 键 词：B型主动脉夹层 血管造影术 数字减影 再破口 

分 类 号：R543.16[医药卫生—心血管疾病] R814.43[医药卫生—内科学]