MSCT在主动脉壁内血肿诊断和转归中的应用  

Application of multi-slice spiral CT in diagnosis and prognosis of aortic artery intramural hematoma

作　　者：黄源义[1] 谢欢[1] 邬正宏[1] 刘四斌[1] 

机构地区：[1]华中科技大学同济医学院附属荆州医院放射科,湖北荆州434020

出　　处：《实用放射学杂志》2011年第12期1823-1825,共3页Journal of Practical Radiology

摘　　要：目的 探讨MSCT在主动脉壁内血肿（IMH）诊断和转归中的应用价值.方法 采用GE 16排螺旋CT对11例IMH行平扫和CTA扫描.3例行腔内支架隔绝术,8例保守治疗.所有病例治疗后随访2～4次,随访时间15～210 d（平均112.5 d）.结果 A型IMH 3例,B 型IMH 8例.MSCT主要征象为：11例主动脉壁新月形或环形增厚＞5 mm,呈等密度或高密度,无内膜片撕裂及真、假两腔形成;主动脉粥样硬化7例;内膜钙化内移4例;内膜渗漏3例;穿透性溃疡3例.7例完全吸收,2例部分吸收,2例进展成夹层动脉瘤.结论 MSCT能对IMH作出明确的诊断,并可作为IMH随访的重要检查手段,对临床治疗有重要的指导意义.Objective To investigate the applied value of multi slice spiral CT in diagnosis and prognoses of aortic artery intramu ral hematoma（IMH）. Methods 11 patients with IMH underwent plain CT scan and CT angiography with 16-slice spiral CT of GE. Endovascular stent for the treatment in 3 cases and conservative treatment in 8 cases was performed. All patients were followed-up twice or 4 times for 15-210 days（mean 112.5 days）. Results 3 cases with Stanford A and 8 cases with Stanford B IMH were diagnosed. The main CT findings were as follows： Crescent or circular thickening（〉5 mm）of aortic wall with higher density or isodensity without intimal flap as well as true and false lumen in 11 cases;atherosclerosis in 7 cases;intimai calcification ingression in 4 cases; intimal leakages in 3 cases;penetrating ulcer in 3 cases. The hematomas in 7 cases were completely absorbed,incomplete absorbed in 2 cases,while 2 cases were transformed to dissecting aneurysm. Conclusion MSCT is a significant method in diagnosis and follow ing-up of IMH, and can provide important informations for clinical treatment.

关 键 词：主动脉 血肿 体层摄影术 X线计算机 

分 类 号：R543.1[医药卫生—心血管疾病] R814.42[医药卫生—内科学]