MSCT诊断不典型主动脉夹层的临床应用研究  

Clinical Exploratory Development of Atypical Aortic Dissection Diagnosed by MSCT

作　　者：余红胜[1] 吉六舟[2] 沈又利[1] 周泉[1] 刘义康[2] 

机构地区：[1]孝感市康复医院放射科,湖北孝感432000 [2]孝感市中心医院放射科,湖北孝感432000

出　　处：《CT理论与应用研究（中英文）》2017年第2期231-239,共9页Computerized Tomography Theory and Applications

摘　　要：目的:分析并总结不典型主动脉夹层(AAD)的MSCT影像表现特征,评价MSCT对该病的临床诊断价值。方法:回顾性分析13例AAD病例的MSCT平扫及CTA征象,诊断参照Stanford分型。结果:Stanford A型3例,B型10例。13例病变主动脉壁呈新月形或环形增厚,平扫呈高密度,增强无强化,5例内膜钙化内移。其中伴内膜渗漏2例、穿透性溃疡3例,主动脉外径增宽3例、管腔内径变窄2例、动脉粥样硬化9例,并发心包积液1例、胸腔积液4例。结论:AAD的CT影像学表现有其特征性,主动脉壁新月形或环形增厚是其特征性影像学表现,可伴有内膜钙化内移、内膜渗漏、穿透性溃疡、主动脉形态改变、动脉粥样硬化等,常并发心包及胸腔积液。MSCT增强前后扫描诊断AAD优势明显,平扫结合临床可以强烈提示AAD,CTA具有确诊价值。Objective： Analyze and summarize the MSCT imaging features of atypical aortic dissection, to evaluate MSCT＇s clinical diagnosis value to the disease. Methods： Retrospectively analyses the MSCT plain scans and CAT signs of 13 AAD cases, diagnosed by referring to the Stanford types. Results： Stanford type A： 3 cases, type B： 10 cases. Their aortic walls showed the meniscus or annular incrassation and plain scans showed high density and increase with no enhancement and 5 cases of inward moving of the calcified inner wall. Including 2 cases of intima leakage, 9 cases of atherosclerosis; 1 case of pericardial effusion, 4 cases of pleural effusion. Conclusion： CT imaging manifestations of AAD have characteristic feature： aortic walls showed the meniscus or annular incrassation, with inward moving of the calcified inner wall, intima leakage, penetrating ulcer, the structure change of aorta, atherosclerosis and so on, which erupt simultaneously pericardial effusion and pleural effusion. The advantage of AAD to scan and diagnose before and after the enhancement is obvious, plain scans combining clinic could strongly suggests that AAD, CTA are of diagnostic values.

关 键 词：不典型主动脉夹层 诊断 血管造影 体层摄影术 X线计算机 

分 类 号：R543.1[医药卫生—心血管疾病] R816.2[医药卫生—内科学]