腹主动脉离断经胸腹腔镜人工血管转流术影像学分析  

Imaging Analysis of Thoracic Laparoscopic Artificial Vascular Bypass for Abdominal Aorta Dissection

作　　者：张道恩 吴应行 任垚 张高峰 夏春潮[2] 刘衡 ZHANG Dao-en;WU Ying-hang;REN Yao;ZHANG Gao-feng;XIA Chun-chao;LIU Heng(Department of Medical Imaging,The Second Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,China;Department of Radiology,West China Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China;Department of Medical Imaging,The Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,China)

机构地区：[1]遵义医科大学第二附属医院医学影像科,贵州遵义563000 [2]四川大学华西医院放射科,四川成都610041 [3]遵义医科大学附属医院医学影像科,贵州遵义563000

出　　处：《中国CT和MRI杂志》2024年第7期127-129,共3页Chinese Journal of CT and MRI

摘　　要：目的分析CT血管成像对成人腹主动脉离断的诊断及经胸腹腔镜人工血管转流术(胸主动脉-腹主动脉搭桥)后疗效评估、随访的应用价值。方法对我院确诊的1例成人腹主动脉离断患者手术前后的临床和影像资料,以及追踪该患者根据临床诊疗评估需要术后2年随访的影像资料一并进行分析。结果术前首次CTA检查:腹主动脉中段(右肾动脉下方层面-腰3椎体上缘水平)未见显示,范围约50mm,考虑闭塞或发育异常。肠系膜上动脉主干及分支明显迂曲扩张,其一分支与下腹主动脉相连。术后1周复查:降主动脉远段与腹主动脉远段间人工血管术后,人工血管通畅。术后第1年和第2年CTA随访结果无明显变化:降主动脉远段与腹主动脉远段间人工血管术后,人工血管通畅,人工血管下段接口处见少量非钙化性斑块形成,管腔未见明显狭窄。结论CT血管成像可以作为腹主动脉离断的术前诊断、胸腹腔镜人工血管转流术术后疗效评估及随访的首选影像检查方法。Objective To analyze the value of CT angiography in the diagnosis of abdominal aortic dissection in adults and the evaluation and follow-up after thoracic laparoscopic artificial vascular bypass(thoracic aorta-abdominal aortic bypass).Methods The clinical and imaging data of an adult patient with abdominal aortic dissection diagnosed in our hospital before and after surgery,and the imaging data of the patient who needs to be followed up for 2 years after surgery according to clinical evaluation were analyzed.Results The first CTA examination before surgery showed that the middle part of the abdominal aorta(the lower level of the right renal artery-the upper margin of the lumbo3 vertebrae)was not visible,with a range of about 50mm,which was considered to be occlusion or abnormal development.The main and branches of the superior mesenteric artery are obviously tortuous and dilated,and one branch is connected with the lower abdominal aorta.Review 1 week after operation:The artificial blood vessels between the distal descending aorta and the distal abdominal aorta were smooth.The results of CTA follow-up at 1 and 2 years after surgery showed no significant changes:the artificial blood vessels were patency after the artificial blood vessels between the distal segment of the descending aorta and the distal segment of the abdominal aorta,and a small amount of noncalcified plaque formation was observed at the lower segment of the artificial blood vessels,and no significant stenosis was observed in the lumen.Conclusion CT angiography can be used as the first choice in the preoperative diagnosis of abdominal aortic dissection,the evaluation of postoperative efficacy and follow-up after thoracic laparoscopic artificial vascular bypass.

关 键 词：腹主动脉离断 血管成像 腔镜 人工血管 

分 类 号：R572[医药卫生—消化系统] R654.3[医药卫生—内科学]