主动脉壁内血肿的多层面螺旋CT诊断

目的:评价多层面螺旋CT诊断主动脉壁内血肿的价值.材料和方法:对23例怀疑主动脉病变的患者进行多层面螺旋CT扫描并诊断为主动脉壁内血肿.两名有经验的心血管放射医师按照CT标准做出诊断.使用16排多层面螺旋CT获得1.25mm层厚(1mm重建间隔)图像,应用多平面重建、曲面重建、最大密度投影和容积重建等方法显示壁内血肿及穿透溃疡.结果:23例主动脉壁内血肿中,1例A型,22例B型;B型壁内血肿中,仅累及降主动脉的8例,胸腹主动脉受累11例,局限于腹主动脉3例;11壁内血肿伴主动脉穿透溃疡,其中2例行带膜内支架治疗.结论:多层面螺旋CT能为主动脉壁内血肿的诊断、鉴别诊断和治疗提供重要信息.

Diagnosis of Aortic Intramural Hematoma with Multislice Helical CT

Purpose: To present the CT findings of aortic intramural hematoma(IMH) and determine the diagnostic value of multislice helical CT(MSCT) for IMH.Materials and Methods: Twenty-three patients who suspected of aortic disease were refered to our hospital and the diagnoses of IMH were made by two experienced vascular radiologists according to the CT criteria.The 1.25 mm slice thickness and 1 mm interval were used to reconstruct images for post-processing using 16-slice helical CT.The multiplanar reconstruction(MPR),curved planar reconstruction(CPR),maximum intensity projection(MIP) and volume rendering(VR) were recruited to delineate the penetrating ulcers and intramural hematoma.Results: Twenty-two of 23 aortic intramural hematoma were Type B,which the descending aorta was involved in 8 cases,thoracic and abdominal aorta were involved in 11 cases and 3 cases located in abdominal aorta.11 patients with IMH were found to be caused by aortic penetrating unlcer and 2 IMHs with penetrating ulcer were treated by graft-stent.The calcification of aortic wall could be found inside or outside IMH.Conclusion: Multislice helical CT can provide important information for the diagnosis and treatment of aortic intramural hematoma.