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时间:2019-05-24
《主动脉夹层破裂并肺动脉壁血肿的CTA表现及临床意义》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、生旦垦兰星堡垄查生箜卷第9期JChinClinMedImaging,2011,Vo1.22,No.9·621·主动脉夹层破裂并肺动脉壁血肿的CTA表现及临床意义曹殿波,郭晖,佟倩,华树成(吉林大学第一医院放射线科,吉林长春130021)【摘要】目的:探讨主动脉夹层(AD)破裂并肺动脉壁血肿的发生机理、CTA表现及其临床价值。材料与方法:收集我院2007年3月~2010年7月行CTA检查并诊断为非外伤性AD病例183例,对其中AD破裂并肺动脉壁血肿及蔓延的3例病例CTA表现、临床治疗方式及效果进行回顾性分析。结果:3例患者临床均以胸骨后疼痛而就诊,年龄45~82岁。CTA检查表
2、现:第一破口位于升主动脉近段累及胸腹主动脉l例、主动脉弓升主动脉侧累及升主动脉1例、主动脉弓降主动脉侧累及胸腹主动脉1例;破口直径大小分别为0.9cm、0.8cm、0.4cm;主肺动脉干壁血肿1例、主肺动脉干及左右肺动脉壁血肿1例、主肺动脉干及左右肺动脉壁血肿和肺泡出血1例。随访中,1例行手术治疗患者至今仍存活,另2例保守治疗患者均于入院48h内死亡。结论:CTA检查不但能明确AD的诊断,还能确定有无夹层破裂外穿并肺动脉壁血肿及蔓延。结合相关文献及本组随访结果.年龄因素与动脉夹层破裂致肺动脉壁血肿并延伸程度是影响患者预后的重要因素【关键词】动脉瘤,夹层;主动脉;血肿;肺动脉;
3、体层摄影术,螺旋计算机;心血管造影术【中图分类号】R543.16;R543.2;R814.42;R814.43【文献标识码】A[文章编号】1008—1062(2011)09—0621—04ClinicalimplicationsandCTAfindingsofthepulmonaryarterialhematomaduetorupturedaorticdissectionCA0Dian—bo,GUOHui,TONGQian,HUAShu-cheag(DepartmentofRadiology,theFirstHospitalofJilinUniversity,Changchu
4、n130021,China)Abstract:Objective:Tostudythemechanism,CTAfindingsandclinicalimplicationsofpulmonaryarterialwallhematomasecondarytorupturedaorticdissection.Methods:Westudied183patientswithnontraumaticaorticdissectionfrom2007to2010inourhospital,diagnoseswereconfirmedbyCTangiography.CTAfindings
5、,treatmentmodalitiesandclinicaloutcomeswereretrospectivelyanalyzedinthreepatientswithpulmonaryarterialwallhematomasecondarytorupturedaorticdissection.Results:These3patientspresentedwithchestpainonadmission.CTAfindingsincluded:theintimaltearlocatedintheproximalportionofascendingaortaextendin
6、gtothoracic—abdominalaortainonecase,aorticarchextendingonlytoascendingaortainthesecondcaseandinthedistalportionofaorticarchinvolvingthoracic—abdominalaortainthethirdcase.Thesizeoftearwas0.9cm.O.8cmand0.4cmrespectively.Thehematomalocatedinthewallofpulmonaryarterialtrunkinonecase,inthewallofp
7、ulmonaryarterytrunkandbilateralpulmonaryarteriesinonecase,inthewallofpul·monaryarterytrunkwithbilateralpulmonaryarteriesandalveloarbleedingoccurredinonecase.Onfollow—up,thepatientwhounderwentsurgerysurvivednOW,whiletheotherpatientswithconservativemanagem
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