多层螺旋CT重建诊断主动脉夹层的应用价值  

Diagnostic Value of Multi-slice Spiral CT Reconstruction for Aortic Dissection

作　　者：高伟 任伟超 马宁 杜静波 吴涛 GAO Wei;REN Wei-chao;MA Ning;DU Jing-bo;WU Tao(Department of Radiology,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China;Department of Neurology,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China;Department of Radiology,the First Affiliated Hospital of Henan Traditional Chinese Medicine Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]首都医科大学大兴教学医院放射科,北京102600 [2]首都医科大学大兴教学医院神经内科,北京102600 [3]河南中医院第一附属医院放射科,河南郑州450000

出　　处：《中国CT和MRI杂志》2023年第5期160-162,共3页Chinese Journal of CT and MRI

基　　金：河南省中医药科学研究专项课题项目(2018ZY2002)。

摘　　要：目的 探讨多层螺旋计算机断层扫描(MSCT)重建诊断主动脉夹层(AD)的应用价值。方法 回顾性选择2017年2月至2022年2月在我院收治的根据相关症状与体征怀疑为AD患者60例,所有患者入组后均接受数字减影血管造影(DSA)和MSCT检查。以DSA检查结果作为诊断的金标准,Kappa一致性分析MSCT对主动脉夹层的诊断效能、DeBakey分型的诊断符合率;比较MSCT与DSA方法对AD相关损伤检出率和真假腔内径水平差异。结果 入组60例患者中,经DSA与MSCT检查诊断为主动脉夹层患者分别有47例(78.33%)和45例(75.00%),经比较无统计学差异(P>0.05)。MSCT检查诊断主动脉夹层的灵敏度、特异度和Kappa值分别为91.49%、84.62%和0.721。经DSA金标准诊断DeBakeyⅠ型、Ⅱ型与Ⅲ型分别有17例、4例和26例,MSCT检查对DeBakey分型的诊断符合率与Kappa值分别为89.36%、0.882。MSCT与DSA在真假腔、内膜破口检出率比较上无明显差异(P>0.05)。MSCT与DSA技术在腹腔干动脉、肠系膜上动脉、肾动脉与髂总动脉分支血管受累比较上无明显差异(P>0.05)MSCT与DSA检查测量真腔最大内径、假腔最大内径水平比较无明显差异(P>0.05)。结论 MSCT诊断AD有较高效能,主要表现在主动脉夹层检出率、DeBakey分型、主动脉病变相关损伤部位等特征上,有利于疾病的早期诊断和治疗方案的选择。Objective To explore the application value of multi-slice spiral computed tomography(MSCT)reconstruction in the diagnosis of aortic dissection(AD).Methods A total of 60 patients with suspected AD due to related symptoms and signs admitted to the hospital were enrolled retrospectively between February 2017 and February 2022.All underwent digital subtraction angiography(DSA)and MSCT after enrollment.Taking DSA results as diagnostic golden standard,the diagnostic efficiency of MSCT for AD and its diagnostic coincidence rate for DeBakey classification were analyzed by Kappa consistency test.The differences in detection rates of AD-related injury,involvement of aortic branches,and diameter of true and false cavities by MSCT and DSA were compared.Results In the 60 patients,DSA and MSCT showed that there were 47 cases(78.33%)and 45 cases(75.00%)with AD,respectively.And the differences was not statistically significant(P>0.05).The sensitivity,specificity and Kappa value of MSCT in the diagnosis of AD were 91.49%,84.62%and 0.721,respectively.DSA showed that there were 17 cases,4 cases and 26 cases with types I,II and III in DeBakey classifications,respectively.The diagnostic coincidence rate and Kappa value of MSCT for DeBakey classifications were 89.36%and 0.882,respectively.There was no significant difference between MSCT and DSA in the detection rate of true and false cavity and endometrial rupture(P>0.05)..There was no significant difference between MSCT and DSA in the involvement of celiac artery,superior mesenteric artery,renal artery and branches of common iliac artery(P>0.05).There was no significant difference in the maximum diameter of true and false cavities between MSCT and DSA(P>0.05).Conclusio n MSCT has high diagnostic efficiency for AD,which is mainly reflected in the detection rates of aortic dissection,DeBakey classifications and aortic lesion-related injuries.And it is conducive to the early diagnosis of diseases and selections of treatment regimens.

关 键 词：主动脉夹层 螺旋计算机断层扫描 DEBAKEY分型 真假腔内径 

分 类 号：R543.1[医药卫生—心血管疾病]