多层螺旋ct在诊断主动脉夹层中价值

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1、多层螺旋CT在诊断主动脉夹层中价值[摘要]目的:回顾性分析主动脉夹层(aorticdissection,AD)的多层螺旋CT造影结果,然后通过正确率来探讨螺旋CT诊断AD的价值。方法:50例AD患者全部行平扫及增强扫描,并结合多平面重组、曲面重组等方法来显示AD及穿透溃疡,根据Stanford分类法分型。结果:对50例AD患者造影结果进行分析,分为A型27例,B型23例,所有患者均显示主动脉夹层典型征象;主要CT表现为主动脉壁呈新月型或环形增厚,无内膜破裂形成的双腔主动脉征象,增强扫描假腔无强化;内膜钙化向内移位14例;穿透性溃疡征6例;并发心包、纵隔及胸腔积液和积血共3

2、0例。结论:螺旋CT能够清楚显示夹层的部位、范围及并发症,可作为主动脉夹层的首选检查及随访方法。[关键词]多层螺旋CT;主动脉夹层;诊断价值[中图分类号]R543[文献标识码]C[文章编号]1674-4721(2010)07(a)-106-02ThevalueofthespiralCTinthediagnosisofaorticdissectionTANGXiaoming(RadiologyDepartmentofRadiologyofYongzhouCityPeople’sHospitalinHunanProvince,Yongzhou8425000,China)[Ab

3、stract]Objective:Aretrospectiveanalysisofaorticdissection(aorticdissection,AD)ofmulti-sliceCTangiography,andthenthecorrectrateofthevalueofhelicalCTdiagnosisofAD.Methods:50casesofADpatientshadallbeenplainandenhancedscan,combinedwithMPR,surfacerestructuringandothermethodstodisplayADandpenet

4、ratingulcer,accordingtostanfordclassificationtype.Results:50casesofADpatientstoanalyzetheimagingresultsof27casesweredividedintotypeA,B23cases,allcaseswereshowtypicalsignsofaorticdissection;themainCTshowedaorticwallshowedcrescentorcircularthickening,withouttheformationofdouble-lumenaortici

5、ntimarupturesignsofenhancedscanfalselumennoenhancement;inwarddisplacementofintimalcalcification14cases,6casesofpenetratingulcersigns,concurrentpericardial,mediastinal,andpleuraleffusionandbloodwerepositivein20cases,throughconservativetreatment,12casesofcompleteabsorption,sixcasesofsomenon

6、-typical8absorption,nosignificantchangesin4cases.Conclusion:SpiralCTcanclearlyshowdissectionofthelocation,extentandcomplicationsofaorticdissectionasthepreferredmethodofinspectionandfollow-up.[Keywords]Multi-sliceCT;Aorticdissection;Diagnosticvalue主动脉夹层(aorticdissection,AD)是一种严重影响人类健康的主动脉疾

7、患,在我国其发病率有明显上升的趋势,早期正确诊断是良好预后的关键,螺旋CT血管造影为非创性血管成像技术,它在大血管病变的诊断、治疗方案的拟定及术后的疗效评价方面有重要的临床应用价值,多层螺旋CT(multislicespiralCT,MSCT)由于扫描速度快,覆盖范围广,短时屏气即可完成主动脉全程的扫描,加上强大的图像后处理功能,非常适宜于主动脉病变的检查[1]。笔者收集了经16层螺旋CT检查诊断的AD患者50例,旨在探讨多层螺旋CT在AD诊断中的临床应用价值,现报道如下:1资料与方法1.1一般资料回顾2007年3月～2009