自发性孤立性内脏动脉夹层的MSCT血管造影  

MSCT Angiography of Spontaneous Isolated Visceral Artery Dissection

作　　者：李鲁[1,2] 李惠民[1] 凃备武[1] 汪登斌[1] 

机构地区：[1]交通大学医学院附属新华医院放射科,上海200092 [2]浙江省金华市中心医院放射科

出　　处：《临床放射学杂志》2014年第10期1551-1555,共5页Journal of Clinical Radiology

摘　　要：目的分析自发性孤立性内脏动脉夹层（SIVAD）的多层螺旋CT血管造影（MSCTA）表现,以提高对其认识。方法回顾性分析29例孤立性内脏动脉夹层患者（男26例,女3例,年龄41～87岁,平均63.1±13.7岁）的临床资料、MSCTA原始薄层横断位图像和三维重建图像（SISMAD 18例,SICAD 11例）,并作Sakamoto分型分析。结果 MSCTA对内脏动脉夹层的内膜片、破口、真假腔及溃疡显示良好。Ⅰ型10例（34.5%）,Ⅱ型6例（20.7%）,Ⅲ型7例（24.1%）,Ⅳ型6例（20.7%）。12例（41.4%）有腹痛症状,其中8例病变动脉周围可见渗出。3例（分别为手术取栓,支架置入和置管溶栓）进行积极处理取得良好疗效。结论 MSCTA可以充分显示孤立性内脏动脉夹层的病变特点并帮助准确分型,有助于临床处置。Objective To analyze the multi-slice spiral computed tomography angiography（MSCTA） features of spontaneous isolated visceral artery dissection（SIVAD） in order to improve the recognition of this disease.Methods During the period from Nov.2006 to Sep.2013,a total of 29 patients with SIVAD were admitted to authors＇ hospital.The patients included 26 males and 3 females with a mean age of（63.1 ± 13.7） years（range 41- 87 years）.MSCTA with 3-D reconstruction imaging was performed in all patients.The clinical data and the imaging findings were retrospectively analyzed,and Sakamoto classification was made.Results The intimal-flap,tearing site,true and false lumens,and ulcers of SIVAD were clearly displayed on MSCTA images.According to Sakamoto＇s classification,ten patients were categorized into type Ⅰ（34.5%）,six patients were categorized into type Ⅱ（20.7%）,seven patients were categorized into type Ⅲ（24.1%）,and six patients were categorized into type Ⅳ（20.7%）.Twelve patients complained of abdominal pain.Exudation around the diseased artery was detected in eight patients.Three patients were treated with surgical removal of thrombus,stenting and transcatheter thrombolytic therapy respectively,and good curative effect was obtained in all the three patients. Conclusion MSCTA can clearly and fully display the characteristic features of SIVAD,which is very helpful for deciding its classification and clinical management.

关 键 词：夹层 内脏动脉 血管造影 体层摄影术 X线计算机 

分 类 号：R543.5[医药卫生—心血管疾病] R816.2[医药卫生—内科学]