CTA在主动脉夹层诊断及介入治疗效果评估中的应用  

Application of CTA in the Diagnosis of Aortic Dissection and Evaluation for the Curative Effect on Interventional Therapy

作　　者：张宪亮[1] ZHANG Xian-liang(Department of Minimally Invasive Interventional,Zhoukou Central Hospital,Zhoukou 466000,Henan Province,China)

机构地区：[1]河南省周口市中心医院介入科

出　　处：《中国CT和MRI杂志》2019年第6期76-78,I0001,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨CT血管造影(CTA)在主动脉夹层(AD)诊断及介入治疗效果评估中的应用价值。方法回顾性分析2015年1月-2017年12月我院收治的36例AD患者临床资料,病例患者均行DSA和CTA检查,评估CTA诊断AD患者原发破口位置的准确性以及Debakey分型准确性,同时分析CTA在AD介入治疗效果评估中价值。结果以DSA诊断结果为金标准,CTA诊断AD患者原发破口位置的准确率为86.11%,CTA诊断AD患者Debakey分型的总体准确率97.22%;25例DebakeyⅢ型AD患者接受覆膜支架腔内修复术治疗,术后两周复查CTA发现7例急性患者出现Ⅰ型近端内漏,为患者行内科保守治疗后自愈,余12例急性AD和6例慢性AD患者术后两周复查CTA均发现假腔内有血栓形成但未见并发症存在,手术成功率100%,近期死亡率为0,术后6个月随访发现1例死亡,死亡率4.00%。结论CTA对AD诊断有非常重要价值,在临床实践工作中可为AD患者介入治疗后近期疗效评估提供重要参考信息。Objective To investigate the application value of CT angiography(CTA) in the diagnosis of aortic dissection(AD) and the evaluation for the curative effect on interventional therapy. Methods The clinical data of 36 patients with AD admitted to the hospital from January 2015 to December 2017 were analyzed retrospectively. All patients underwent DSA and CTA examination. The accuracies of CTA for the diagnosis of the primary break location of AD patients and Debakey types were evaluated. The value of CTA in the evaluation for the curative effect on AD interventional therapy was analyzed. Results Taking the DSA diagnosis results as the golden standard, the accuracy of CTA in the diagnosis of primary break location of AD patients was 86.11%. The overall accuracy of CTA in the diagnosis of Debakey types of AD patients was 97.22%. A total of 25 AD patients of Debakey Ⅲ type were given transluminal stent-graft placement. After 2 weeks of the surgery, CTA reexamination found there were 7 acute cases with type Ⅰ proximal endoleak. The patients were self-healing after given medical conservative treatment. Among the remaining 12 cases with acute AD and 6 cases with chronic AD, CTA reexamination after 2 weeks of the surgery found that there was thrombosis in the pseudocoele but no complications. The success rate of surgery and the recent mortality were 100% and 0, respectively. There was 1 case died after 6 months of surgery by followup. And the mortality was 4.00%. Conclusion CTA is of great value in the diagnosis of AD. It can provide important reference information for the short-term curative effect evaluation of AD patients after interventional therapy in clinical practice.

关 键 词：主动脉夹层 双源CT血管造影 介入治疗 效果评估 

分 类 号：R543.16[医药卫生—心血管疾病] R814.42[医药卫生—内科学]