多层螺旋CT在主动脉壁内血肿诊断中的临床应用

目的 探讨分析多层螺旋CT在主动脉壁内血肿（AIH）诊断中的影像学表现及应用价值.方法 回顾分析19例经临床和多层螺旋CT证实的主动脉壁内血肿的CT影像特征及临床表现,结合多层螺旋CT后处理技术,概括分析血肿的部位、厚度、形态、累及范围及血肿强化情况以及并发症等.结果 在19例AIH病患中,参考stanford分型,A型4例,B型15例;主动脉管壁均为环形或新月形增厚,厚度≥5 mm,平扫密度多样,可为高密度或等密度或混杂密度,增强扫描未见强化;其中显示：钙化内移17例,动脉粥样硬化16例,穿透性溃疡征像11例.继发胸腔积液14例,心包积液4例,胸膜增厚2例,主动脉瘤3例.结论 多层螺旋CT可直观、清晰显示AIH的直接和间接征象,能为AIH的诊断和治疗提供重要信息,对AIH的诊断和临床应用有重要价值.

Clinical use of MSCT in diagnosis of aortic intramural hematoma

Objective To analyze the imaging findings and value of application of multislice CT in the diagnosis of aortic intramural hematoma （AIH）.Methods Retrospective analysis was conducted to 19 cases confirmed by clinical and MSCT aortic intramural hematoma of the CT imaging features and clinical manifestations,combining with multislice CT post-processing technique,then we summarized and analyze the part of the hematoma,thickness,shape,involving the scope and hematoma reinforcement and complications.Results 19 cases of AIH were diagnosed by references of Stanford type,4 cases were type A,and type B 15 cases; Thickening of the aortic wall were circular or crescent,thickness ≥ 5 mm,or scan density was diversiform,can provide high density,such as density or mixed density,enhanced scan did not see strengthening; displays：calcification in 17 cases,16 eases of atherosclerosis,penetrating ulcer like 11 cases.14 cases of pleural effusion and 4 cases of pericardial effusion,pleural thickening in 2 cases,aortic aneurysm in 3 patients.Conclusion MSCT can he intuitive,clear display direct and indirect signs of AIH,and it provides important information for the diagnosis and treatment of AIH,with important clinical application value for the diagnosis of AIH.