主动脉壁内血肿多层螺旋CT血管成像的影像学表现  

Imaging manifestations of multi-slice spiral CT angiography in aortic intramural hematoma

作　　者：罗世雯 LUO Shiwen(Radiology Department,the Third People’s Hospital of Nanning,Guangxi,Nanning 533000,China)

机构地区：[1]南宁市第三人民医院放射科,广西南宁533000

出　　处：《中国医药科学》2023年第15期149-152,161,共5页China Medicine And Pharmacy

摘　　要：目的探究对主动脉壁内血肿患者实施多层螺旋CT血管成像诊断,其影像学具体表现及诊断价值。方法回顾性选择2020年3月至2022年3月南宁市第三人民医院82例主动脉壁内血肿患者,均给予多层螺旋CT血管成像诊断,通过多平面重建、最大密度投影以及曲面重建,继而观察并分析主动脉壁内血肿患者受累解剖部位、分型、影像学特征以及厚度对受累主动脉管径造成的影响。结果多平面重建(MPR)、横断位以及最大密度投影(MIP)及曲面重组(CPR)均可以直接显示主动脉壁内血肿病变特征,平扫环形、新月形高密度影对主动脉壁内血肿的急性期确定诊断有价值。环形、新月形稍高密度影分别有44、38例,平均CT值(42.86±14.56)HU。主动脉弓、升主动脉以及胸段降主动脉及腹主动脉是主动脉壁内血肿患者的主要受累部位,本研究82例主动脉壁内血肿患者,受累主动脉共82例,其中胸降主动脉37例(占比41.57%)、腹主动脉25例(占比28.08%)、升主动脉18例(占比20.22%),主动脉弓9例(占比10.11%)。82例主动脉壁内血肿患者,Stanford A型共有19例(占比23.17%),其余63例均为Stanford B型(占比76.82%)。主动脉壁内血肿的并发症以合并主动脉穿透性溃疡、主动脉夹层为主,本研究中合并主动脉穿透性溃疡患者有9例(占比10.97%),以“主动脉管壁不光滑”为主要表现,且局限性龛影形成。结论对主动脉壁内血肿患者实施多层螺旋CT血管成像诊断具有显著价值,可直接反映主动脉壁内血肿患者影像学特点,继而帮助临床尽早并准确开展治疗工作。Objective To explore the s pecific imaging manifestations and diagnostic value of multi-s lice spiral CT angiography diagnosis of patients with aortic intramural hematoma.Methods This study was a retrospective study conducted from March 2020 to March 2022.A total of 82 patients with aortic intramural hematoma treated in the Third People’s Hospital of Nanning were included in this study.All patients were diagnosed with multislice spiral CT angiography through multiplanar reconstruction,maximum intensity projection,and curve planar reconstruction,followed by observation on and analysis of the influence of affected anatomical sites,types,imaging characteristics,and thickness on the diameter of the affected aorta in patients with aortic intramural hematoma.Results Multiplanar reconstruction(MPR),transverse section and maximum intensity projection(MIP),and curve planar reconstruction(CPR)can directly display the characteristics of aortic intramural hematoma.Circular and crescent-shaped high-density shadows in plain scans can help determine the diagnosis of an acute phase of IMH.There were 44 cases and 38 cases of circular and crescent-shaped slightly highdensity shadows respectively,with mean CT values of(42.86±14.56)HU.The aortic arch,ascending aorta,thoracic descending aorta,and abdominal aorta are the main affected parts of patients with aortic intramural hematoma.In this study,a total of 82 patients with aortic intramural hematoma were all involved in the aorta,including 37 cases in the thoracic descending aorta(41.57%),25 cases in the abdominal aorta(28.08%),18 cases in the ascending aorta(20.22%),and 9 cases in the aortic arch(10.11%).Among 82 patients with aortic intramural hematoma,19 cases were Stanford A type(23.17%),and the remaining 63 cases were all Stanford B type(76.82%).Complications of aortic intramural hematoma were mainly accompanied by penetrating aortic ulcer and aortic dissection.In this study,there were 9 patients(10.97%)with concomitant penetrating aortic ulcers,with an"unsmooth aortic wall"

关 键 词：主动脉壁内血肿 多层螺旋CT 血管成像 影像学特点 

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