640层容积CT对支架“象鼻”手术治疗Stanford A型主动脉夹层的临床应用  

Clinical application of 640-slice volume CT angiography on ＂elephant trunk＂ stent-graft in treatment of type Stanford A aortic dissection

作　　者：边云[1,2] 王莉[1] 陆建平[1] 刘崎[1] 许兵[1] 康钦钦[1] 宋涛[1] 潘春树[1] 陈超[1] 

机构地区：[1]第二军医大学长海医院影像科,上海200433 [2]中国人民解放军411医院医学影像科

出　　处：《实用放射学杂志》2013年第3期369-372,共4页Journal of Practical Radiology

摘　　要：目的 探讨640层CT对Stanford A型主动脉夹层支架“象鼻”手术治疗后的影像学特征及其术后评价价值。方法 回顾性分析Stanford A型43例主动脉夹层患者经支架“象鼻”手术治疗后的640层CT成像检査资料，所有患者的图像分析及后处理工作均在Vitrea后处理工作站上完成。重建方法包括多平面重建（MPR）、最大密度投影法（MIP）、容积再现技术（VR）等多种后处理方法。重点观察与分析人工血管和“象鼻”支架的位置、形态、支架有无内漏，假腔情况。结果 43例病人中，术后恢复良好的有32例，其中25例降主动脉夹层内有血栓形成，6例降主动脉夹层内有部分血栓形成。术后发生支架内漏11例，均为Ⅰ型内漏。结论 640层CT血管造影是一种方便、快捷和无创的检查手段，综合原始及各种后处理图像可以准确诊断并客观地评价主动脉夹层手术后的情况，是主动脉夹层诊断及随访的重要影像检査方法之一。Objective To evaluate the clinical application of 640-slice CT angiography after ＂elephant trunk＂stent-graft treatment of type Stanford A aortic dissection. Methods 640-slice CT angiography was performed in 43 cases with aortic dissection after ＂elephant trunk＂ stent-graft treatment. 3D reconstruction techniques, including VR, SSD, MIP, and MPR, were adopted. The location and morphology of the artificial vascular and ＂elephant trunk＂ stent, leakage, false lumen were emphatically observed and analysed. Results The operation was successful in 32 cases. Complete thrombosis at the false lumen was found in 25 cases and partial thrombosis was found in 6 cases. Postoperative leakage of stent was found in 11 cases and all were type I. Conclusion 640-slice CT angiography is a convenient , handy and non-invasive inspection means in evaluating ＂elephant trunk＂ stent-graft in treatment of type Stanford A aortic dissection ,and it can be regarded as one of the important means in clinical diagnosis and following-up aortic dissection.

关 键 词：主动脉夹层 主动脉 血管成像 计算机体层成像 “象鼻”手术 

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