电子束CT诊断累及升主动脉及主动脉瓣的大动脉炎  

Aorto-arteritis (Takayasu′s arteritis) involving ascending aorta and aortic valve: electron beam CT diagnosis

作　　者：金敬琳[1] 戴汝平[1] 阮英茆[2] 何沙[1] 王红月[2] 曹程[1] 吕建华[1] 荆宝莲[1] 白桦[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院放射科,北京100037 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院,北京病理科100037

出　　处：《中华放射学杂志》2001年第1期45-48,共4页Chinese Journal of Radiology

摘　　要：目的　探讨电子束CT(EBCT)诊断累及升主动脉及主动脉瓣的大动脉炎的临床价值。方法　自 1996年 4月至 1999年 9月 ,2 5例大动脉炎患者接受了EBCT检查。采用美国Imatron公司15 0 XP型EBCT扫描机 ,扫描方式 :采用增强单层容积扫描 (SSM) ,扫描层厚 3mm ,扫描时间 0 1s,心电门控 ;连续容积扫描 (CVS) ,层厚 3mm ,扫描时间 0 1s。非离子型对比剂 ,30 0mgI/ml。其中 17例累及升主动脉及主动脉瓣 ,4例因重度主动脉瓣关闭不全行换瓣手术 ,病理诊断大动脉炎。 2例 2年后因瓣周漏再次行换瓣手术。结果　 17例均有升主动脉壁不同程度的管壁增厚且延续至主动脉瓣水平 ;活动期 10例动脉管壁增厚呈环状高密度影或分层状 ,内壁光滑。非活动期 7例管壁增厚程度轻 ,呈低密度环。 11例升主动脉扩张 ,左心室扩大 ,主动脉瓣中 重度关闭不全。 4例手术换瓣患者病理所见符合大动脉炎所见。结论　大动脉炎基本CT征象是动脉壁增厚 ,累及升主动脉者可同时累及主动脉瓣 ,造成主动脉瓣关闭不全 ,活动期应为手术禁忌证。EBCT对检出此类大动脉炎有重要价值并且可反映大动脉炎的病程。Objective To evaluate the clinical value of EBCT in the diagnosis of aorto arteritis (Takayasu′s disease) involving ascending aorta and aortic valve. Methods EBCT was carried out by Imatron 150 XP system using contrast enhancement (non ionic contrast media 300 mg I/ml) in 25 patients with aorto arteritis during the period from Apr, 1996 to Sept, 1999. Among the series of 25 cases, ascending aorta and aortic valve were involved in 17 patients (14 females, 3 males). The age ranged from 11 to 58 years with mean age of (34± 13) years. ECG gated single slice mode (SSM) was performed with slice thickness of 3 mm and scanning time of 0 1 s; continues volume scanning (CVS) was performed with slice thickness of 3 mm and scanning time of 0 1 s. The EBCT features of ascending aorta and aortic valve were analyzed in the 17 cases with aorto arteritis. Four patients of these cases had severe aortic insufficiency and underwent operation of aortic valve replacement. Two years later, circumvalve leak occurred in two of these four cases and relived with aortic valve replacement again. Results EBCT image showed the thickening of ascending aortic wall in all 17 cases, and all the lesions extended to the aortic valve. EBCT features of wall thickening appeared as a concentric wall thickening or double density ring in 10 patients with active disease and low density ring in 7 patients with inactive disease. 11 of these patients showed ascending aortic dilation with aortic valve regurgitation. Conclusion Wall thickening of aorta was the basic feature in EBCT images. According to our study, aorto arteritis (Takayasu′s disease) involving ascending aorta can also involve aortic valve and resulte in aortic valve regurgitation. Active stage of aorto arteritis was the contraindication of surgery therapy. EBCT was an important method for the diagnosis of aorto arteritis (Takayasu′s arteritis) and the stage of aorto arteritis can be reflected by EBCT.

关 键 词：TAKAYASU动脉炎 电子束CT 大动脉炎 诊断 

分 类 号：R816.2[医药卫生—放射医学]