CTA结合MRA在DeBakeyⅠ-Ⅲ型主动脉夹层诊断价值上的研究  

Study on the diagnostic value of DeBakey Ⅰ-Ⅲ aortic dissection with CTA as the main diagnosis and MRA as the auxiliary

作　　者：赵晓培 Zhao Xiaopei(Anyang People's Hospital,Anyang,Henan 455000)

机构地区：[1]安阳市人民医院,河南安阳455000

出　　处：《辽宁医学杂志》2023年第6期23-26,共4页Medical Journal of Liaoning

摘　　要：目的探究以电子计算机断层扫描血管成像(CTA)诊断为主磁共振血管成像(MRA)为辅对DeBakey Ⅰ-Ⅲ型主动脉夹层诊断价值。方法选取2019年3月至2021年3月本院收治的80例主动脉夹层患者作为研究对象,分析所有患者行MRA和CTA诊断DeBakey Ⅰ-Ⅲ型主动脉夹层的影像表现,比较二者影像表现异同、诊断效能,并做出联合诊断价值。结果80例患者中有76例扫描成功,共显示76条主动脉,其中Ⅰ型19例,Ⅱ型5例,Ⅲ型52例。针对CTA诊断后可发现,MIP与VR对于初始破口的显示率比较低,而MPR对于初始破口和真假腔内膜瓣的显示率优于MIP和VR;MRA诊断虽然可以通过真腔识别高信号,但Ⅰ型、Ⅱ型、Ⅲ型主动脉真假腔信号相近,难以区分。其中通过影像学诊断科发现主动脉夹层假腔中有附壁血栓形成52例(65.00%),真假腔之间破口48例(61.25%);最终确诊后DeBakey Ⅰ-Ⅲ患者例数分别为21例、6例、53例。通过CTA诊断发现有4例漏诊。通过MRA诊断虽然不能够准确区分DeBakey分型,但是其对于真假腔信号敏感度较高,因此两者互补,能够准确对DeBakey Ⅰ-Ⅲ进行分型。最终可发现CTA结合MRA联合诊断的准确度、敏感度、阳性预测值明显高于CTA单一诊断和MRA单一诊断(P<0.05)。结论应用CTA诊断为主要诊断,并以MRA作为辅助诊断,能够借助CTA对DeBakey Ⅰ-Ⅲ型不同影像学特征对分型进行辨别,并联合MRA对于主动脉夹层的敏感性,提升DeBakey Ⅰ-Ⅲ型主动脉夹层的诊断效能。Objective To explore the diagnostic value of DeBakey type Ⅰ-Ⅲ aortic dissection,which is mainly diagnosed by computed tomography angiography(CTA)and supplemented by magnetic resonance angiography(MRA).Methods 80 patients with aortic dissection admitted to our hospital from March 2019 to March 2021 were selected as the research objects,and the imaging manifestations of all patients diagnosed by MRA and CTA in the diagnosis of DeBakey type Ⅰ-Ⅲ aortic dissection were analyzed,and the imaging manifestations of the two were compared.Similarities and differences,diagnostic efficiency,and the value of joint diagnosis.Results 76 out of 80 patients were successfully scanned,showing 76 aortas,of which 19 were type Ⅰ,5 were type Ⅱ,and 52 were type Ⅲ.After the diagnosis of CTA,it can be found that the display rate of MIP and VR for the initial breach is relatively low,while the display rate of MPR for the initial breach and true and false endoluminal flaps is better than that of MIP and VR;although MRA diagnosis can be identified by the true cavity High signal,but the true and false lumen signals of type Ⅰ,type Ⅱ,and type Ⅲ aorta are similar,which is difficult to distinguish.Among them,52 cases(65.00%)of mural thrombosis were found in the false cavities of aortic dissection through the imaging diagnosis department,and 48 cases(61.25%)were breached between the true and false cavities;the number of patients with DeBakey Ⅰ-Ⅲ after the final diagnosis was respectively 21 cases,6 cases,53 cases.4 cases of missed diagnosis were found through CTA diagnosis.Although MRA diagnosis cannot accurately distinguish DeBakey classification,it is more sensitive to true and false cavity signals,so the two complement each other and can accurately classify DeBakey Ⅰ-Ⅲ.Finally,it can be found that the accuracy,sensitivity,and positive predictive value of combined diagnosis of CTA and MRA were significantly higher than that of CTA single diagnosis and MRA single diagnosis(P<0.05).Conclusion With CTA diagnosis as the ma

关 键 词：MRA CTA DeBakeyⅠ-Ⅲ型 主动脉夹层诊断 诊断价值 

分 类 号：R543.1[医药卫生—心血管疾病]