外伤性主动脉夹层的CT诊断(附2例报告)  

CT diagnosis of traumatic aortic dissection(with a report of 2 cases)

作　　者：李金矿[1] 龚福林[1] 范伟[1] 黄书娟[1] 李军凤[1] 严华[1] 袁冬[1] 

机构地区：[1]钟祥市人民医院特放科,湖北431900

出　　处：《放射学实践》2014年第4期447-449,共3页Radiologic Practice

摘　　要：目的:探讨外伤性主动脉夹层的早期CT表现。方法:回顾性分析在我院漏诊及确诊的外伤性主动脉夹层的CT表现。2例中1例行3次CT平扫,1例行CT平扫和增强扫描。结果:2例均为DeBakeyⅢ型主动脉夹层,1例3次CT平扫示降主动脉管腔进行性增宽,伴双侧胸腔积液;此例因漏诊,患者于2周后死亡。另1例CT平扫示降主动脉增粗,CT增强扫描明确诊断,主要表现为降主动脉扩张,可见真腔、假腔及内膜线;此例患者行支架植入术后,患者预后良好。结论:对于胸部外伤患者,CT平扫时应注意观察主动脉的直径,如果降主动脉增粗、尤其是进行性增粗时,应考虑主动脉夹层的可能。Objective：To study the CT features of the traumatic aortic dissection （AD） and improve the early diagnostic accruary of AD. Methods： The CT features of two patients with traumatic aortic dissection confirmed by autopsy （in one case） and stent implantation after DSA （in another case） were analyzed retrospectively. Of the two cases,one case underwent three times of plain CT, one was performed with plain and contrast-enhanced CT scan. Results： The two cases were both of DeBakey type Ill of aortic dissection. In one case, progressive expansion of the descending aorta with bilateral pleural effusions was showed on plain CT and follow-up CT images. In another case,expansion of the descending aorta was showed on plain CT,and then multi-slice CT angiography showed the signs of AD,including true and false lumen and intimal flap, and confirmed the diagnosis of AD. Conclusion： For patients with chest trauma, it is important to analyze the dimension change of the aorta on plain CT scan, and ecstasis especially progressive ecstasis of descending aorta can be an important sign for the diagnosis of AD.

关 键 词：主动脉夹层 外伤 体层摄影术 X线计算机 血管成像 诊断 

分 类 号：R816.2[医药卫生—放射医学] R543.1[医药卫生—临床医学]