CT平扫在疑似主动脉夹层中的诊断价值  

Application of non-enhanced computed tomography in patients with suspected aortic dissection

作　　者：李金燕[1,2] 王锡明[1,2] 段艳华[2] 杨世锋[3] 纪晓鹏[1,2] 曹婷[1,2] 齐耀东[2] 

机构地区：[1]山东大学医学院山东省医学影像学研究所,山东济南250021 [2]山东省医学影像学研究所山东省心脑血管疾病诊治重点实验室,山东济南250021 [3]山东省立医院医学影像科,山东济南250021

出　　处：《医学影像学杂志》2015年第1期60-64,共5页Journal of Medical Imaging

摘　　要：目的探讨非强化CT扫描在疑似主动脉夹层患者中的诊断价值。方法收集来我院就诊疑似主动脉夹层行多层螺旋CT检查(平扫+强化扫描)的85例患者资料,其中主动脉夹层患者60例,非主动脉夹层者25例,由2名医师在不知道临床信息及强化CT结果的情况下回顾性分析其平扫图像,记录诊断准确性。结果在所测参数中,清晰内膜片对主动脉夹层的敏感性、特异性、阳性预测值分别为50%、100%、100%,清晰内膜片+模糊内膜片对主动脉夹层的诊断敏感性提高到80%,更重要的是,如果和其他征象(如钙化内移、高密度血肿等)联合诊断,则非强化CT的诊断敏感性将更高。结论 CT平扫多征象组合对主动脉夹层有较好的诊断价值,是主动脉夹层的一种有效诊断方法。Objective To evaluate the application of non-enhanced computed tomography （CT） in patients with suspected aortic dissection （AD）. Methods Eighty-five patients with suspected AD underwent MDCT, of which AD was confirmed in 60 and ruled out in 25. Non-enhanced CT data of all patients were retrospectively accessed by 2 independent observers unaware of clinical information and enhanced CT results. The diagnostic performance of non-enhanced CT parame- ters to detect AD was calculated. Results Among the parameters, positive intimal flap had a sensitivity of 50%, a speci ficity of 100%, a positive predictive vale （PPV） of 100%, and a negative predictive value of 100%, respectively. The addition of equivocal intimal flap （positive＋ equivocal or positive alone） increased the sensitivity to 80%. Furthermore, if combined with other parameters （such as high density area in the aorta or deviation of aortic calcification）, the sensitivity would be better improved. Conclusion The combination of non-enhanced CT parameters had a good diagnostic efficiency, which could be an effective diagnostic method.

关 键 词：主动脉夹层 体层摄影术 X线计算机 内膜片 诊断 

分 类 号：R543.1[医药卫生—心血管疾病] R814.42[医药卫生—内科学]