胸主动脉夹层动脉瘤腔内隔绝术前裂口的评估  

PREOPERATIVE EVALUATION OF THE TEARS OF THORACIC AORTIC DISSECTIONS BEFORE ENDOVASCULAR GRAFT EXCLUSION

作　　者：赵珺[1] 景在平[1] 赵志青[1] 包俊敏[1] 王振堂[1] 叶华[1] 杨继金[1] 

机构地区：[1]第二军医大学长海医院,上海200433

出　　处：《解放军医学杂志》2001年第9期634-637,共4页Medical Journal of Chinese People's Liberation Army

基　　金：军队杰出人才基金 (编号 98J0 0 5 );上海市卫生系统百人计划基金(编号 97BR0 47);上海长海医院学科攀登计划基金资助课题

摘　　要：为探讨胸主动脉夹层动脉瘤腔内隔绝手术前裂口评估的意义及方法 ,作者分析了 32例以螺旋CT为主要术前检查评估方式、少数采用MRA检查的病例 ,并与术中DSA对比。结果表明 ,第一裂口发现率CT检查为 90 32 % ,MRA为 6 6 7% ,DSA为 10 0 % ;大部分裂口位于断面片时钟位的 3～ 7点 ;多裂口情况下CT与DSA检查结果有一定差异。提示术前准确评估裂口将有利于手术方案、移植物的选择 ;To evaluate the significance and methods of preoperative revealing of the tears of thoracic aortic dissections before endovascular graft exclusion, 32 cases were studied. Among them, 26 cases were evaluated with spiral CT only, 5 with CT and MR together, while one with MR only. Compared with intra operative Digital Subtraction Angiography, the detectable rate of CT,MR and DSA for revealing the tears was 90 32%, 66 7%, and 100% respectively.The most frequently appeared locations of the tears were at the section between 3 and 7 o'clock. In the case of multi entrances, the results evaluated with CT were different from those with DSA. It is concluded that accurate evaluation of the tears would be profitable to stent grafts selection and operative decision, and spiral CT images are most effective in preoperative evaluation of the tears.

关 键 词：胸主动脉夹层动脉瘤 腔内隔绝术 手术前 裂口 螺旋CT 

分 类 号：R543.16[医药卫生—心血管疾病]