感染性主动脉瘤的CT血管成像特征  

CT Angiography Features of Infective Aortic Aneurysm

作　　者：赵娜 侯小明 张兴华[2] 张晶[2] 李涛[2] 袁充 ZHAO Na;HOU Xiaoming;ZHANG Xinghua;ZHANG Jing;LI Tao;YUAN Chong(Department of Radiology,the First Medical Center of PLA General Hospital,Beijing 100853,China;不详)

机构地区：[1]河北省直属机关第一门诊部放射科,河北石家庄050000 [2]解放军总医院第一医学中心放射诊断科,北京100853

出　　处：《中国医学影像学杂志》2023年第11期1218-1221,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨感染性主动脉瘤(IAA)的CT血管成像(CTA)表现。资料与方法回顾性分析2011年6月—2022年1月解放军总医院第一医学中心确诊为IAA的9例患者共10个动脉瘤,收集临床和CTA资料,分析动脉瘤及瘤周的CTA表现。结果9例患者中病原学检查血培养阳性5例。病灶位于主动脉弓1个、腹主动脉6个(肾型1个、肾下型5个)、髂动脉3个,均为假性动脉瘤,表现为偏心性囊状、分叶状,动脉瘤最大径为(42.60±12.02)mm,破口大小为(11.30±4.03)mm,3个管壁可见钙化。动脉瘤周围表现为软组织影,7个伴有不同程度的不均匀强化,6个瘤周脂肪间隙模糊,9个瘤体周围见多发增大淋巴结。结论CTA能清晰显示IAA的形态学特征,当瘤体表现为假性动脉瘤,呈偏心性囊状、分叶状,瘤周出现软组织肿块并强化、周围脂肪间隙模糊、肿大淋巴结,特别是观察到脓肿和气体时,要高度警惕IAA的可能。Purpose To study the CT angiography(CTA)features of infective aortic aneurysm(IAA).Materials and Methods Nine patients(ten lesions)diagnosed as IAA in the First Medical Center of PLA General Hospital from June 2011 to January 2022 were retrospectively analyzed,clinical and CTA data were collected,and imaging manifestations of aneurysms and peritumor were analyzed.Results Five patients were positive in blood culture.The lesions were distributed in aortic arch(one lesion),abdominal aorta(six lesions,including one renal type and five subrenal type)and iliac artery(three lesions),all of which were pseudoaneurysms with eccentric saccular and lobulated shape.The average maximum diameter of aneurysms was(42.60±12.02)mm.The mean rupture size was(11.30±4.03)mm.There were three aneurysms with calcification in the wall.There were soft tissue masses around the aneurysm,accompanied by heterogeneous enhancement(seven lesions)and periaortic soft tissue stranding(six lesions)and enlarged lymph nodes(nine lesions).Conclusion CTA can clearly display the morphological characteristics of IAA.The possibility of IAA should be highly vigilant when the tumor body presents as a pseudoaneurysm with a partial cystic and lobulated shape,soft tissue mass and enhancement around the tumor,blurring of the surrounding fat space,enlarged lymph nodes,especially abscess and gas are observed.

关 键 词：主动脉瘤 感染 假性动脉瘤 体层摄影术 X线计算机 

分 类 号：R543.16[医药卫生—心血管疾病] R445.3[医药卫生—内科学]