升主动脉局限性内膜撕裂CT血管成像的影像学特征分析  

Investigation of imaging features of limited intimal tear of ascending aorta based on CT angiography

作　　者：沈文婷 徐怡[1] 王云飞 殷凡 施夏韵 朱晓梅[1] SHEN Wenting;XU Yi;WANG Yunfei;YIN Fan;SHI Xiayun;ZHU Xiaomei(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029

出　　处：《南京医科大学学报(自然科学版)》2025年第2期227-232,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(82302163);南京医科大学第一附属医院青年学者培养基金(PY2022036)。

摘　　要：目的:探讨急性主动脉综合征(acute aortic syndrome,AAS)患者升主动脉局限性内膜撕裂(limited intimal tear,LIT的影像特点,比较LIT与其他AAS病变的影像学差异。方法:回顾性收集212例升主动脉AAS和212例正常对照组的主动脉CT血管成像资料,其中主动脉夹层(aortic dissection,AD)120例,壁内血肿(intramural hematoma,IMH)52例,LIT 40例。影像学参数包括病变处和无病变处升主动脉、相应层面降主动脉的长短径和管腔面积;计算主动脉重构指数(长径/短径)。结果:LIT组无病变处升主动脉长径大于AD组、IMH组(P均<0.05),病变处管腔重构指数也高于AD组、IMH组(P均<0.05)。二元Logistic回归结果提示无病变处升主动脉长径是发生LIT的独立预测因子(OR=1.533,P<0.001)。结论:LIT的影像学参数与其他AAS病变存在差异;当怀疑AAS患者的升主动脉长径>40.5 mm时,临床需警惕LIT。Objective:To investigate the imaging features of limited intimal tear(LIT)of ascending aorta in patients with acute aortic syndrome(AAS),and compare the imaging differences between LIT and other types of AAS.Methods:CT angiography(CTA)data of 212 patients with AAS and 212 normal controls were retrospectively enrolled.There were 120 cases of aortic dissection(AD),52 cases of intramural hematoma(IMH)and 40 cases of LIT.The imaging parameters included maximal diameter,minimal diameter and area of the ascending aorta at the lesion,adjacent normal ascending aorta and descending aorta at corresponding level respectively.Aortic remodeling index was calculated as maximal diameter/minimal diameter.Results:The maximal diameter of involved ascending aorta in LIT group were larger than those in AD group and IMH group(P<0.05),the remodeling index was also higher than that in the AD group and IMH group(P<0.05).Binary logistic regression analysis suggested that the maximal diameter of ascending aorta was an independent predictor of LIT occurrence(OR:1.533,P<0.001).Conclusion:The imaging parameters of LIT are different from those of other types of AAS lesions.When the maximal diameter of the ascending aorta was greater than 40.5 mm in patients with suspected AAS,LIT should be considered clinically.

关 键 词：急性主动脉综合征 局限性内膜撕裂 主动脉夹层 主动脉壁内血肿 CT血管成像 

分 类 号：R814.42[医药卫生—影像医学与核医学]