主动脉夹层的临床与影像学诊断

目的分析主动脉夹层(AD)的临床特点及诊断,探讨各种影像学表现及其诊断价值.方法对32例AD患者的临床表现及各种影像学表现进行回顾性分析.结果AD的主要病因是高血压,突发剧烈胸背痛是其首发和主要症状,胸部平片是其筛查手段,计算机断层扫描(CT)、经胸超声心动图(TTE)有很高的敏感性,核磁共振显像(MRI)准确率最高,数字减影血管造影(DSA)多于手术治疗前确立诊断或行腔内隔绝术时进行.结论AD起病急、病情凶险、临床表现复杂,及时选择或联合应用X线胸片、TTE、CT、MRI等辅助检查是确诊的重要手段,并指导正确的治疗方向.

Imaging diagnosis and clinical characteristics of aortic dissection

Objective To analyze the diagnostic and clinical characteristics of aortic dissection (AD) and to evaluate the imaging findings and their clinical significance. Methods The clinical characteristics and imaging findings in 32 AD patients were analyzed retrospectively. Results Hypertension was the primary pathogen for AD. The first and main symptoms included acute chest and back pain. Chest X ray examination was the screening method for AD. Computerized tomography (CT) and transthoracic echocardiogram (TTE) had higher sensitivity, and magnetic resonance imaging (MRI) had the highest accuracy. Digital subtraction angiography (DSA) was performed mainly for preoperative diagnosis or endovascular graft exclusion. Conclusion The clinical characteristics of AD include sudden onset, high risk, and varied and complicated clinical manifestations. Option of one or all of the chest X ray examinations, including TTE, CT, MRI, and DSA, may be the most important method for the diagnosis of AD.