孤立性肠系膜上动脉夹层的多层螺旋CT血管成像表现  

Diagnostic value of multi-slice spiral CT angiography in spontaneous isolated dissection of the superior mesenteric artery

作　　者：李硕丰[1] 车延旭[1] 杨琳[1] 冉繁德[1] 张永志[1] 李新春[1] 董妍宏[1] 王彦[1] 

机构地区：[1]沧州市中心医院放射科,河北沧州061001

出　　处：《实用放射学杂志》2012年第12期1922-1925,共4页Journal of Practical Radiology

摘　　要：目的 探讨多层螺旋CT血管成像（MSCTA）在孤立性肠系膜上动脉夹层（SIDSMA）诊断中的应用价值。方法对7例SIDSMA患者行MSCT扫描，采用最大密度投影（MIP）、曲面重组（CPR）、多平面重组（MPR）、容积再现（VR）等多种技术进行图像后处理。结果按照Sakamoto分型标准：Ⅰ型3例，Ⅱ型2例，Ⅲ型1例，Ⅳ型1例。7例肠系膜上动脉（SMA）病变段均有增粗，最大径10．2-13．1mm。近端内膜破裂口与SMA开口距离6．7-49．7mm。6例假腔主要位于真腔腹侧，1例似腔值于真腔右侧4。7例夹层真腔受压狭窄，假腔内血栓形成4例。4例夹层累及SMA分支。SMA周围脂肪间隙模糊2例。结论MSCTA能为SIDS-MA的临床诊断和治疗提供有价值的信息，可作为SIDSMA诊断的首选影像学方法。Objective To evaluate the value of multi-slice spiral CT angiography （MSCTA） in the diagnosis of spontaneous isola-ted dissection of the superior mesenteric artery （SIDSMA）. Methods 7 patients with SIDSMA were performed MSCT scanning. Various image post-processing techniques such as maximum intensity projection （MIP）, curved planar reformation （CPR）, multi planar reconstruction （MPR） and volume rendering （VR） were applied. Results According to Sakamoto＇s classification, three cases were type, two cases were type Ⅱ , one case was type Ⅲ and one case was type Ⅳ The 7 patients＇ SMA lesions segments diameter were enlarged. Maximum diameter was 10.2- 13. 1mm. The distance hetween proximal intimal rt, pture and SMA opening was 6.7-49.7 mm. False cavities mainly located in the ventral of the true lumen in 6 patients. 1 false cavity located on tbe right side of the true lumen. The dissection true lumens were narrowed because of compression in the7 patients. The thrombosis were presented in false lumens in 4 patients. 4 patients showed dissection involving SMA branches. The fat clearance fuzzy were presented in the 2 patients. Conclusion MSCTA plays an important role in clinical diagnosis and treatment of SIDSMA.

关 键 词：夹层 肠系膜上动脉 计算机体层成像 血管成像 

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