彩色多普勒超声与CT血管成像诊断单中心206例Stanford B型主动脉夹层对照分析  

Color Doppler ultrasound versus CT angiography for diagnosing Stanford type B aortic dissection:a comparison analysis of 206 cases from a single cente

作　　者：刘凤菊[1] 程颐[1] 濮欣[2] 黄连军[2] LIU Fengju;CHENG Yi;PU Xin;HUANG Lianjun(Department of Comprehensive Ultrasound,Beijing Anzhen Hospital,Capital Medical University,Beijing100029,China)

机构地区：[1]首都医科大学附属北京安贞医院综合超声科 [2]首都医科大学附属北京安贞医院介入影像科

出　　处：《介入放射学杂志》2023年第9期849-854,共6页Journal of Interventional Radiology

摘　　要：目的以CT血管造影(CTA)为诊断金标准,对照分析彩色多普勒超声(CDUS)诊断Stanford B型主动脉夹层(AD)的准确性。方法2017年10月至2021年11月在北京安贞医院经DSA明确诊断的206例Stanford B型AD患者纳入研究。男性153例,女性53例,年龄(55.3±9.3)岁(28~77岁)。DSA术前3 d内完成主动脉及其分支CTA和CDUS检查。以术前CTA诊断分析结果为金标准,探讨CDUS对AD诊断指标的显示率、诊断准确率和漏诊率。CDUS与CTA测量结果对照分析采用配对t检验。结果CDUS诊断B型AD准确率为100%(206/206)。AD双腔显示率100%,内膜片显示率93.2%(192/206),真假腔诊断准确率88.8%(183/206),AD累及范围符合率95.6%(197/206),假腔血栓显示率72.5%(66/91),降主动脉原发破口显示率68.9%(142/206),远端再破口显示率64.6%(360/557),内脏分支(肾动脉、肠系膜上动脉、腹腔干动脉)受累形式符合率83.7%~100%,内脏分支(肾动脉、肠系膜上动脉、下肢动脉)灌注不良诊断符合率100%(17/17、9/9、3/3)。降主动脉原发破口大小、原发破口距左锁骨下动脉开口距离、主动脉各节段最宽处管腔内径、真腔内径、假腔内径与CTA测量值对照差异无统计学意义(均P>0.05)。结论CDUS是一种快速、简单诊断Stanford B型AD的方法,可与CTA良好匹配。Objective Taking computed tomography angiography(CTA)as the gold standard to analyze the accuracy of color Doppler ultrasonography(CDUS)in diagnosing Stanford type B aortic dissection(AD).Methods A total of 206 patients with Stanford type B AD,which was proved by DSA at Beijing Anzhen Hospital of China between October 2017 and November 2021,were enrolled in this study.The patients included 153 males and 53 females,with a mean age of(55.3±9.3)years(range of 28-77 years).CTA and CDUS examinations of aorta and its branches were accomplished within 3 days before treatment under DSA.Taking preoperative CTA diagnosis as the gold standard,the sign display rate,the diagnostic accuracy,and the missed diagnosis rate of CDUS for diagnosing AD were calculated.The imaging findings of CDUS and CTA were analyzed by using paired t-test.Results In making examination by using CDUS,the diagnostic accuracy for Stanford type B AD was 100%(206/206),the display rate of AD double lumen was 100%,the display rate of intimal flap was 93.2%(192/206),the diagnostic accuracy rate for true and false lumen was 88.8%(183/206),the accuracy rate in diagnosing AD involvement extent was 95.6%(197/206),the display rate of false lumen thrombosis was 72.5%(66/91),the display rate of the original tear in the descending aorta was 68.9%(142/206),the display rate of the distal tear was 64.6%(360/557),the accuracy of diagnosing the affected pattern of visceral branches(including renal artery,superior mesenteric artery,and celiac trunk artery)was 83.7%-100%,the accuracy of diagnosing the poor perfusion of visceral branches(including renal artery,superior mesenteric artery,and lower extremity artery)was 100%(17/17,9/9,and 3/3 respectively).No statistically significant differences in the primary tear size of the descending aorta,the distance between the primary tear and the opening of left subclavian artery,the inner diameter of the lumen at the widest segment of the aorta,the true lumen diameter,and the false lumen diameter existed between CDUS measurements

关 键 词：主动脉夹层 彩色多普勒超声 超声心动图 计算机断层摄影血管造影 血流动力学 

分 类 号：R543.1[医药卫生—心血管疾病]