主动脉壁内血肿的影像学分析

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1、【摘要】目的：探讨主动脉壁内血肿的影像学诊断和鉴别诊断，为临床诊断工作提供可靠的参考依据。方法：选择2013年1月-2014年12月笔者所在医院经临床检查证实为主动脉壁内血肿的46例患者，分析其胸部X线平片、CT及MRI特点，对比X线、CT以及MRI诊断主动脉壁内血肿的准确率。结果：46例主动脉壁内血肿，表现为主动脉壁环形增厚17例，新月形增厚15例，环形和新月形增厚同时存在或不规则增厚14例，腔内无内膜片及真假两腔形成，增厚的血管壁内无对比剂进入。胸部X线平片、增强CT、MRI均可见阳性征象，CT、MRI直接观察到病变程度及累及的范围。X线、M

2、RI以及CT诊断主动脉壁内血肿的准确率分别为60.0%、71.7%、100%。结论：CT扫描及MRI成像能够诊断较为典型的主动脉壁内血肿，并与主动脉其他常见疾病相鉴别，是主动脉壁内血肿诊断的有效手段，综合分析临床表现利于早期确诊，加强血压控制利于病变稳定。【关键词】主动脉疾病；壁内血肿；影像学诊中图分类号R445文献标识码B文章编号1674-6805(2015)21-0066-03【Abstract】Objective：Toexploretheimagingdiagnosisanddifferentialdiagnosisofaorticintr

3、amuralhematoma.Method:46casesofaorticintramuralhematomawhichwereconfirmedbyclinicalexaminationfromJanuary2013toDecember2014wereselected.ItschestX-rayplainfilm，CTandMRIcharacteristicswereanalyzed，andtheiraccuracywerecompared.Result：Amongthe46casesofaorticintramuralhematoma，17c

4、asesshowedcircularaorticwallthickening,15casesshowedcrescentthickening，14casesshowedbothcircularandcrescentthickeningorirregularthickening.Therewasnointimalflap,notrueandfalselumenformation，andnocontrastagententeredthethickeningbloodvesselwall.Positiveimagingsignscouldbedemon

5、stratedonplainchestradiograph,enhancedCT，MRI.CTandMRIcoulddirectlydisplaythedegreeandextentofthelesion.TheaccuracyindiagnosisofCT、MRIandX-rayreached100%，71.7%，60.0%respectively.Conclusion:AtypicalaorticintramuralhematomacanbediagnosedbyMRIorCT，anditis中图分类号R445文献标识码B文章编号1674-6

6、805(2015)21-0066-03【Abstract】Objective：Toexploretheimagingdiagnosisanddifferentialdiagnosisofaorticintramuralhematoma.Method:46casesofaorticintramuralhematomawhichwereconfirmedbyclinicalexaminationfromJanuary2013toDecember2014wereselected.ItschestX-rayplainfilm，CTandMRIcharac

7、teristicswereanalyzed，andtheiraccuracywerecompared.Result：Amongthe46casesofaorticintramuralhematoma，17casesshowedcircularaorticwallthickening,15casesshowedcrescentthickening，14casesshowedbothcircularandcrescentthickeningorirregularthickening.Therewasnointimalflap,notrueandfal

8、selumenformation，andnocontrastagententeredthethickeningbloodvesselwa