64排螺旋CT血管成像在主动脉夹层中的诊断优势

目的:探讨64排螺旋CT血管成像技术在主动脉夹层中的诊断优势。方法:对23例主动脉夹层患者均行MSCTA检查,采用容积重建、多平面重建及曲面重建等方法进行三维重建。结果:DeBakeyⅠ型8例(34.8%),Ⅱ型3例(13.0%),Ⅲ型12例(52.2%),壁内血肿3例。主动脉重要分支受累5例(21.7%),均在三维重建中有特征表现。横轴位图像上可观察到真假腔形态、大小、剥脱的内膜片、破口位置及内膜和主动脉壁钙化,MPR重建图像能观察主动脉弓受累情况,确定内膜剥离范围,显示内膜与各分支血管之间的关系。结论:64排螺旋CT血管三维重建能直观、立体显示真、假腔的形态、大小、破口位置及其与大分支血管的关系,是诊断主动脉夹层的首选检查方法。

The Advantages of 64-slice Spiral CT Angiography in the Diagnosis of Aortic Dissection

Objective:Discuss the advantages of 64-slice spiral CT angiography in the diagnosis of aortic dissection.Methods:23 patients with aortic dissection underwent 64-slice CT scan without and with contrast enhancement.The CT scan data were transferred into AW4.3 workstation and were postprocessed by using multiplanar reconstruction(MPR) and volume rendering technique(VRT).Results:Axial CT scan clearly showed the shape and size of true lumen and false lumen,desquamative intimal pieces,location of entry tears,and intramural calcification of the aorta.The images of MPR directly and stereoscopically showed the involved the length of aortic arches,the extent of intimal dissection,and the correlation between intima and great branch vessels.According to DeBakey classification,there were 8 cases of type 1,3 cases of type 2,12 cases of type 3,and 3 cases of in intramural aortic hematoma(IMH)in the group patients.Conclusion:64-slice CT can clearly show the shape and size true and false lumen,the location of entry tears and its relation with great branch vessels so that it should be first choice to diagnosis this disease.