主动脉壁增厚病变的CTA诊断及鉴别诊断  

CTA Diagnosis and Differential Diagnosis of Aortic Wall Thickening

作　　者：荆彦平[1] 黄敏[1] 郭振安 吴连强[1] 王熹 王茹茹 王彦桃 程敬亮[3] JING Yan-ping;HUANG Min;GUO Zhen-an;WU Lian-qiang;WANG Xi;WANG Ru-Ru;WANG Yan-tao;CHENG Jing-liang(Imaging Department,the Affiliate Huanghe Sanmenxia Hospital of Henan University of Science and Technology,Sanmenxia 472000,Henan Province,China;Vasculocardiology Department,the Affiliate Huanghe Sanmenxia Hospital of Henan University of Science and Technology,Sanmenxia 472000,Henan Province,China;Imaging Department,the First Affiliated Hospital Zhenzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]河南科技大学附属黄河三门峡医院影像科,河南三门峡472000 [2]河南科技大学附属黄河三门峡医院心血管内科,河南三门峡472000 [3]郑州大学第一附属医院影像科,河南郑州450052

出　　处：《中国CT和MRI杂志》2023年第7期63-65,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨主动脉壁增厚病变的CTA诊断价值,以提高对本病的诊断及鉴别诊断水平,把控疾病预后。方法分析经临床确诊的主动脉壁增厚病变34例,包括主动脉夹层8例,主动脉壁间血肿6例,主动脉粥样硬化附壁血栓16例,多发性大动脉炎2例,lgG4相关动脉周围炎2例的影像资料。结果34例中,主动脉夹层8例,见撕裂破口及内膜片,真假腔,3例见分支血管受累,3例呈螺旋形撕裂走形;主动脉壁间血肿6例,2例见钙化内膜内移,内膜无破口,管壁新月形,不对称增厚,内缘光滑,不强化;主动脉粥样硬化附壁血栓16例,呈腔内低密度充盈缺损,不强化,不光滑,多发,位于血管内膜内侧,引起管腔不同程度狭窄;多发性大动脉炎2例,局限性管壁环形增厚,有强化,管腔狭窄;lgG4相关动脉周围炎2例,主动脉壁周围管壁不均匀增厚,范围较长,内膜光整,管腔狭窄不明显,周围组织强化。结论主动脉夹层见双腔及内膜片,主动脉壁间血肿见钙化内移、不强化增厚管壁及光滑的内壁,主动脉粥样硬化附壁血栓见管腔不光滑的充盈缺损,多发性大动脉炎见局限性管壁环形增厚强化,管腔狭窄,lgG4相关动脉周围炎见管壁外的不均匀增厚、强化为特点,主动脉壁增厚病变影像表现具有一定特点,CTA对主动脉壁增厚病变诊断优势明显。Objective To study the diagnostic value of CTA in aortic wall thickening,so as to improve the diagnosis and differential diagnosis of this disease and control the prognosis of the disease.Methods The imaging data of 34 patients with clinically confirmed thickening of aortic wall were analyzed,including 8 cases of aortic dissection,6 cases of intermural hematoma,16 cases of aortic atherosclerotic mural thrombosis,2 cases of multiple arteritis,and 2 cases of lgG4-related periarteritis.Results Among the 34 cases,aortic dissection was found in 8 cases,with laceration and internal diaphragm,true and false lumen,involvement of branch vessels in 3 cases,and helical tearing in 3 cases.There were 6 cases of intermural hematoma of aorta,and 2 cases showed inward calcification of intima,no intima rupture,crescent-shaped wall,asymmetrically thickened,smooth inner edge,no enhancement.16 cases of aortic atheroclerotic mural thrombus presented low-density filling defects in the lumen,which were not enhanced,not smooth,and multiple,located in the inner intima of blood vessels,causing varying degrees of stenosis in the lumen.2 cases of multiple arteritis showed annular thickening,enhancement and lumen narrowing.2 cases of lgG4-related periarteritis showed uneven thickening of the periaortic wall,long range,smooth intima,insignificant lumen stenosis and surrounding tissue enhancement.Conclusion See double cavity and inner diaphragm,aortic dissection of aortic intramural hematoma calcification ingression,strengthening wall thickening and smooth inner wall,aortic atherosclerosis mural thrombus see lumen not smooth filling defect,see multiple aorto arteritis limitations wall annular thickening reinforcement,luminal stenosis,lgG4-related periarteritis is characterized by uneven thickening and enhancement outside the wall,aortic wall thickening lesions imaging performance is characterized,and CTA has obvious advantages in the diagnosis of aortic wall thickening.

关 键 词：主动脉壁增厚 主动脉夹层 主动脉壁间血肿 

分 类 号：R543.1[医药卫生—心血管疾病]