感染性主动脉炎CT血管成像特点分析  

Imaging spectrum of the CTA in infectious aortitis

作　　者：李宇[1] 张楠[1] 孙立忠[2] 徐磊[1] LI Yu;ZHANG Nan;SUN Lizhong;XU Lei(Depart-ment of Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所医学影像科,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心外科,100029

出　　处：《心肺血管病杂志》2019年第9期962-966,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家卫生和计划生育委员会:公益性行业科研专项项目(201402009)

摘　　要：目的:探讨感染性主动脉炎的影像学特点。方法:回顾性分析38例临床明确诊断的主动脉感染,分析病变位置、形态、血管壁厚度、强化方式、瘤体周围渗出、邻近组织器官改变及淋巴结等;查阅临床处理方法并随诊,观察感染性动脉瘤不同处理方法的预后。结果:男性36例,平均发病年龄(59.6±14.08)岁。腹主动脉是最好发部位,最常见的病原菌是非伤寒沙门菌、结核及布鲁菌病;常表现为假性动脉瘤(37/38),瘤壁线状或分隔状强化,78.9%的瘤体附近有增大淋巴结,结核及布鲁菌病患者常有邻近椎体骨质破坏及腰大肌脓肿。保守治疗及单纯支架治疗效果较差,手术治疗配合严格抗生素治疗预后较好。结论:CT平扫及增强可以明确感染性假性动脉瘤的形态特点,为术前诊断、治疗方案制定提供帮助。Objective: To explore the imaging spectrum of infectious aortitis. Methods: 38 consecutive patients with infectious aortitis were recruited. The infected location, morphology, wall thickening, conrast medium uptake in the wall, perivascular streaking and fluid accumulation,infected lymph nodes, spondylodiscitis, psoas abscess were all evaluated. Follow-up was performed to summarize the result of different management. Results: The male is predominant and the average age is(59.6±14.08) years old. Abdominal aorta with arteriosclerosis is the most common involved site. Salmonella typhimurium,Mycobacterium tuberculosis and Brucellosis are frequent microorganisms causing aortic infection. Mycotic aneurysms which was irregular in shape, with thick and irregular wall or septa was common. Infected lymph nodes could be found in 78.9% patients. Spondylodiscitis and psoas abscess were more popular in patients with Mycobacterium tuberculosis and Brucellosis. The antimicrobial therapy and endovascular aortic repair alone were all poor prognosis. Antimicrobial therapy, surgical excision of the infection focus and reconstruction of the affected aortic segment offer the best prospect for the complete resolution of infections. Conclusions: CT scan play an important role in diagnosis and management strategy.

关 键 词：感染性动脉炎 感染性动脉瘤 假性动脉瘤 

分 类 号：R54[医药卫生—心血管疾病]