比较彩色多普勒超声与CT对腹主动脉夹层动脉瘤的诊断价值  

Comparison of Color Doppler Ultrasound and CT in the Diagnosis Value of Abdominal Aortic Dissection Aneurysm

作　　者：常漪潇 辛红艳 禹凯鸣 贾慧娟 CHANG Yixiao;XIN Hongyan;YU Kaiming;JIA Huijuan(Department of Ultrasound Medicine,Zhengzhou Third People’s Hospital,Zhengzhou Henan 450000,China;Department of Ultrasound Medicine,Zhengzhou Jinshui District General Hospital,Zhengzhou Henan 453000,China;Department of Hepatobiliary and Gastric Diseases,Zhoukou Traditional Chinese Medicine Hospital,Zhoukou Henan 466000,China)

机构地区：[1]郑州市第三人民医院超声医学科,河南郑州450000 [2]郑州市金水区总医院超声医学科,河南郑州453000 [3]周口市中医院肝胆脾胃科,河南周口466000

出　　处：《临床研究》2023年第12期136-139,共4页Clinical Research

摘　　要：目的比较彩色多普勒超声与CT对腹主动脉夹层动脉瘤的诊断价值。方法选取2018年5月至2020年5月在河南省省立医院接受治疗的52例疑似腹主动脉夹层动脉瘤患者,以症状体征、主动脉造影结果为诊断金标准,分别进行CT检查、彩色多普勒超声检查,分析其彩色多普勒超声检查结果、血流情况及征象,比较诊断符合率,分析CT检查表现,比较两种检查方法的诊断效能(敏感性、特异性、阳性预测值、阴性预测值)。结果彩色多普勒超声检查结果显示,主动脉内径扩张约42~85 mm,内膜出现一端游离(随心脏跳动而飘动)另一端相连情况,动脉腔出现主动脉真腔与假腔,真腔血流速度快于假腔,血流颜色更鲜亮,收缩期真腔血液进入假腔,舒张期反之;其中12例患者动脉明显增宽,23例动脉壁分离,18例主动脉瓣轻度返流,10例破口,8例冠状动脉受累,3例肾动脉受累,1例存在胸腔积液,3例存在心包积。CT检查结果显示,主动脉内膜由主动脉壁向腔内移动5 mm以上,可见裂开、撕裂的内膜片,呈现线样低密度影,可见真假两腔;症状体征、主动脉造影结果显示共确诊32例,且彩色多普勒超声检查诊断符合率高于CT检查,且主动脉破口数、累及分支血管数目、夹层血栓形成、动脉壁钙化也高于CT检查,差异有统计学意义(P<0.05)。彩色多普勒超声检查诊断敏感性、特异性、阳性预测值、阴性预测值高于CT检查,差异有统计学意义(P<0.05)。结论彩色多普勒超声检测应用于腹主动脉夹层动脉瘤患者临床诊断中效果较好,有利于提高疾病检出率,效果优于CT。Objective To compare color doppler ultrasound and CT in the diagnosis value of abdominal aortic dissection aneurysm.Methods A total of 52 suspected patients with abdominal aortic dissecting aneurysm who received treatment at Henan Provincial Hospital from May 2018 to May 2020 were selected,for CT examination and color Doppler ultrasound examination based on symptoms,signs,and aortic angiographyResults as the diagnostic gold standard.The Results,blood flow,and signs of color Doppler ultrasound examination were analyzed.The diagnostic accuracy was compared.The CT examination manifestations were analyzed,compare the diagnostic efficacy of two examination Methods(sensitivity,specificity,positive predictive value,negative predictive value).Results The results of color Doppler ultrasonography showed that the inner diameter of the aorta was expanded by about 42-85 mm,and one end of the intima appeared free(fluttering with the beating of the heart)and the other end.In the case of connection,the true aortic lumen and the false lumen appeared in the arterial lumen.The blood flow rate of the true lumen was faster than that of the false lumen,and the color of blood flow was brighter.The blood in the true lumen entered the false lumen in systole,and vice versa in diastole.The arteries of 12 patients were obviously widened,23 cases of arterial wall separation,18 cases of mild aortic valve regurgitation,10 cases of rupture,8 cases of coronary artery involvement,3 cases of renal artery involvement,1 case of pleural effusion,3 cases of pericardial accumulation.The CT examination results showed that the intima of the aorta moved more than 5mm from the aortic wall to the lumen,revealing cracked and torn intimal patches,presenting as linear low-density shadows and showing true and false lumens.The symptoms,signs,and aortic angiographyResults showed that a total of 32 cases were confirmed.Compared with the CT examination,the diagnostic accuracy of color Doppler ultrasound examination was higher(P<0.05),and the number of aortic ruptur

关 键 词：彩色多普勒超声 腹主动脉夹层动脉瘤 有效性 临床诊断 

分 类 号：R730.4[医药卫生—肿瘤]