超声联合CTA在Stanford A型主动脉夹层术后随访中的应用价值  

Clinical Application of Ultrasound and CTA in Postoperative Follow-up of Stanford A Type Aortic Dissection

作　　者：朱晓丽[1] 王峥[1] 郑敏娟[1] 刘丽文[1] 徐磊[1] 刘从伟[2] 

机构地区：[1]第四军医大学西京医院超声科,西安市710032 [2]第四军医大学西京医院放射科,西安市710032

出　　处：《中国超声医学杂志》2016年第9期794-796,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金(No.81301228)

摘　　要：目的探讨超声联合CTA在Stanford A型主动脉夹层动脉瘤术后随访中的应用价值。方法回顾性分析48例经手术证实为Stanford A型主动脉夹层动脉瘤患者术前、术后临床常规资料、常规超声以及术后CTA的检查结果。结果常规超声示,与术前相比较,47例患者术后左室心腔大小、容积显著缩小,左室收缩功能显著增加(P<0.05)。2例患者颈内静脉内血栓形成。术后CTA结果显示:48例人工血管及支架血流通畅,未见吻合口瘘,1例腹主动脉段假腔内再次破裂,17例(35%)患者左肾动脉起自假腔。结论常规超声可评估Stanford A型主动脉夹层患者术后心内及颈部血管并发症、心功能情况。CTA可评估冠状动脉、肾动脉受累情况及支架吻合口情况。两者联合可对Stanford A型主动脉夹层患者术后疗效情况进行全面、真实、有效的评估,从而能有效地评估患者的病情及预后,对指导临床治疗有重要价值。Objective To explore the clinical value of ultrasound and computed tomography angiography （CTA） in postoperative follow-up in patients with Stanford A type aortic dissection. Methods A total of 48 cases Standford A type aortic dissection were enrolled in this study. Preoperative and postoperative clinical data and conventional ultra-sound imaging data were analyzed retrospectively, and postoperative CTA data was analyzed. Results Compared with preoperative data, the size of left ventricular （LV） cavity was significantly reduced after operation, and LV systolic function was significantly increased on conventional echocardiography（P〈0.05）. Internal jugular vein thrombosis was found in 2 cases. Postoperative CTA results showed that there was no blood flow obstacle and no anastomotic leak in 48 cases with artificial blood vessel and stent, 1 case of false lumen rupture in abdominal aorta, 17 cases （35%） with left renal artery arising from the false lumen. Conclusions Intracardiac and cervical vascular complications and cardiac function in patients with Stanford A type aortic dissection can be objectively evaluated by conventional ultra- sound. Coronary artery, renal artery involvement and stent anastomosis were more easily detected by CTA. Based on the combination of conventional ultrasound and CTA, an overall, accurate and effective assessment can be made in Stanford A type aortic dissection patients after operation. It is important in clinical therapy guidance.

关 键 词：A 型主动脉夹层 超声心动图 CTA 

分 类 号：R445.1[医药卫生—影像医学与核医学] R654.2[医药卫生—诊断学]