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目的:探讨MRI对主动脉瘤伴主动脉夹层的诊断价值及其表现。材料与方法:10例主动脉瘤伴主动脉夹层病人于临床症状出现后1天至360天接受了磁共振成像,其中男性8例,女性2例,年龄25~63岁(平均43岁)。5例呈急性发病,而另5例为慢性发病。半数以上的病人有高血压病史。对所有病人的磁共振成像,均采用了Siemens超导机Magnetom Impact 1.0T。结果:10例病人按受累部位分别归类为DeBakey Ⅰ型1例,Ⅱ型2例,以及Ⅲ型7例。结论:磁共振成像技术对主动脉瘤伴主动脉夹层病人的诊断,具有其他方法所不能比拟的精确性。 相似文献
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胸主动脉夹层动脉瘤血管内支架介入治疗 总被引:2,自引:0,他引:2
目的探讨腔内隔绝术(EVGE)治疗胸主动脉夹层动脉瘤(TAD)的技术和方法。资料与方法TAD55例,支架为记忆合金自膨支架和超薄涤纶人工血管的复合体,直径根据螺旋CT血管造影(CTA)和主动脉数字减影血管造影(DSA)确定。在DSA引导下沿导丝经真腔将该复合体封闭内膜破口和假腔。结果55例共置入63个支架,其中置入1个支架48例,2个支架6例,3个支架1例。内漏9例。术中死亡1例,54例术后康复良好。手术后CT随访。结论术前准确影像学评价,选择适当口径、长度的支架和术中准确定位夹层裂口和正确判断夹层真、假腔是EVGE治疗成功的关键。肠系膜上动脉、肾动脉受累并不是绝对禁忌症。EVGE创伤小,安全度高,是当前治疗TAD的新颖、高效、首选的介入治疗方法。 相似文献
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Furlow B 《Radiologic technology》2005,77(1):41-9; quiz 50-2, 74
This article discusses the anatomy and pathobiology of the aorta, common aortic emergencies and their diagnosis, and the roles and limitations of diagnostic imaging in assessment, medical intervention and monitoring. 相似文献
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《Journal of vascular and interventional radiology : JVIR》2020,31(8):1334-1341
PurposeTo evaluate feasibility and efficacy of thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) associated with retrograde type A intramural hematoma (IMH).Materials and MethodsFrom April 2013 to January 2017, 15 consecutive patients with TBAD associated with retrograde type A IMH who underwent TEVAR were reviewed retrospectively. There was no cardiac tamponade, aortic regurgitation, involvement of coronary artery, or sign of cerebral ischemia in these patients. Enhanced CT was used in 4 patients to diagnose malperfusion of abdominal visceral arteries or lower extremity artery and underwent emergent TEVAR. For the remaining 11 patients, repeated enhanced CT after initial medical treatment within 24 hours from onset of pain showed expansion of IMH in 8 patients or presence of periaortic hematoma in 3 patients. Delayed TEVAR was scheduled for these cases.ResultsSuccessful deployment of the stent graft was achieved in all patients. There were no severe postoperative complications, such as retrograde type A aortic dissection or aortic rupture. Sudden death occurred in 1 patient 3 months after the procedure. Thrombosis of the false lumen, shrinkage of the diameter of the aorta, and complete absorption of the IMH were observed in the remaining patients at a mean follow-up of 19.8 months ± 6.57.ConclusionsTEVAR for treatment of TBAD with retrograde type A IMH is feasible and effective. It represents a treatment option for patients with TBAD associated with type A IMH with a proximal entry tear located in the descending aorta. 相似文献
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目的 :提高影像学诊断先天性主动脉瓣、瓣上及瓣下狭窄的水平。材料和方法 :主动脉瓣狭窄 12例 ,主动脉瓣下狭窄 5例 ,主动脉瓣上狭窄 7例 ,均行X线检查 ,MRI 2 1例 ,心血管造影 (CAG) 15例 ,手术证实 15例。结果 :主动脉瓣狭窄MRI显示瓣膜增厚、瓣口狭窄 2例 ;主动脉瓣下隔膜型狭窄MRI示 3例 ,CAG示 1例 ;MRI示主动脉瓣上纤维嵴型狭窄 6例及发育不良型狭窄 1例。结论 :X线平片难以提供确定诊断的依据 ;超声心动图对主动脉瓣上狭窄的诊断有限 ;除主动脉瓣狭窄外 ,MRI可弥补超声心动图诊断中的不足 ,二者结合可达到术前诊断的目的 ,除特殊适应症外 ,无须行CAG检查。 相似文献
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Nordon IM Hinchliffe RJ Loftus IM Morgan RA Thompson MM 《Cardiovascular and interventional radiology》2011,34(5):890-902
Acute aortic syndrome (AAS) describes several life-threatening aortic pathologies. These include intramural hematoma, penetrating
aortic ulcer, and acute aortic dissection (AAD). Advances in both imaging and endovascular treatment have led to an increase
in diagnosis and improved management of these often catastrophic pathologies. Patients, who were previously consigned to medical
management or high-risk open surgical repair, can now be offered minimally invasive solutions with reduced morbidity and mortality.
Information from the International Registry of Acute Aortic Dissection (IRAD) database demonstrates how in selected patients
with complicated AAD the 30-day mortality from open surgery is 17% and endovascular stenting is 6%. Despite these improvements
in perioperative deaths, the risks of stroke and paraplegia remain with endovascular treatment (combined outcome risk 4%).
The pathophysiology of each aspect of AAS is described. The best imaging techniques and the evolving role of endovascular
techniques in the definitive management of AAS are discussed incorporating strategies to reduce perioperative morbidity. 相似文献
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主动脉夹层:3D DCE MRA诊断 总被引:6,自引:1,他引:5
探讨3D DCE MRA对主动脉夹层诊断的价值及其检查技术。材料和方法:共作主动脉夹层28例3D DCE MRA检查。采用3D FSGR,团注Gd-DTPA 20ml,屏气扫描时间16-22秒。经工作站进行了MIP和MPR重建。结果:分析28例主动脉夹层3D DCT MRA表现,发现3D DCE MRA为主动脉夹层的上下范围,内膜片,破口,真两腔以及分支受累情况均能满意显示。 相似文献
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目的:总结主动脉血管支架置入术治疗Stanford B型主动脉夹层的临床经验。方法:术前对15例Stanford B型主动脉夹层患者进行主动脉全程薄层增强CT扫描及血管成像,以获得主动脉夹层病变解剖学特征。在局麻下行主动脉造影,并与CT结果比较,选取支架血管型号。全麻下切开左股动脉或右股动脉,置入支架血管,封堵原发破口,重复造影检查有无内漏。术后1周及1年行CT随访,观察有无内漏、支架移位和假腔变化。结果:15例均获临床成功。1例见少量近端内漏,未发生其他并发症。CT随访,5例主动脉夹层消失,余者假腔内血栓形成。结论:与传统手术相比,腔内隔绝术治疗Stanford B型主动脉夹层具有创伤小、并发症少、安全性高等优点,近期疗效满意。 相似文献
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Ristić-Andelkov A Gligić B Damnjanović M Milovanović J Matunović R Obradović S 《Vojnosanitetski pregled. Military-medical and pharmaceutical review》2003,60(2):167-174
There is a long latent period in the clinical course of aortic valve stenosis in adults. Symptoms usually occur in the case of critical stenosis, when aortic orifice area is under 0.7 cm2 (0.4 cm2/m2). In this study 78 patients with critical aortic valve stenosis were investigated. The first manifestation of the disease was dyspnea (78.2%), angina (52.5%), less often a syncope (34.6%), while 17.9% of patients were asymptomatic. Left ventricular systolic function was preserved in 77% of patients, while left ventricular dyastolic dysfunction occurred in almost all the patients. In 42 patients (53.4%) aortic valve replacement was performed. Left ventricular systolic function improved in 88.1% of patients postoperativelly, as well as in patients with preoperatively preserved or poor systolic function. Recovery was fast particularly during the first 6 postoperative months. After the surgery the improvement of the left ventricular dyastolic function was slower then systolic, particularly in patients with extreme hypertrophy of myocardium in whom the process of recovery might last several years. 相似文献
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Stereomicroradiographic images of timed-gestation mouse embryos clarify aortic development and help one to understand human vascular anomalies. 相似文献