自发孤立性肠系膜上动脉夹层CT血管造影诊断

目的探讨自发孤立性肠系膜上动脉夹层（SISMAD）的CT血管造影（CTA）特征。方法回顾性分析2011年1-7月间在深圳市南山人民医院接受腹腔动脉双源CTA检查的25例不明原因的急性腹痛患者的临床资料。结果CTA检查发现4例肠系膜上动脉夹层,均为男性,年龄（45．3±6．7）岁．2例有高血压病史。4例患者CTA检查均发现肠系膜上动脉管径增粗,2例呵见内膜瓣和真假腔．1例溃疡状破口,1例壁间血肿,近段破口均位于肠系膜上动脉近段;CTA分型：Ia型2例,Ⅱb型1例。Ⅲ型1例。2例出院时进行了DSCTA复查,出现了进行性变化。结论CTA可清晰显示肠系膜上动脉夹层的特征．并能为疾病分型和随访观察提供重要依据。

Diagnosis of spontaneous isolated superior mesenteric artery dissection using computed tomography angiography

Objective To investigate the characteristics of the spontaneous isolated superior mesenteric artery dissection（SISMAD） on computed tomography angiography（CTA）. Methods Twenty- five patients with unexplained acute abdominal pain received CTA. Results Four cases with the SISMAD were found and all were male with a mean age of （45.3±6.7） years. Two patients had hypertension history. CT showed enlarged diameter of the superior mesenteric artery with dissection in 4 cases, intimal flap and visible false lumen in 2 cases, ulcer-like laceration in 1 ease, and intramural hematoma in 1 case. The proximal lacerations or entries were all at the proximal segment of the superior mesenteric artery. CTA classifications were type I a （n=2）, ]Ⅱb （n=l）, and Ⅲ （n=1）. Two patients underwent repeated CTA when discharged, and progressive changes were discovered. Conclusion CTA can clearly show the characteristics of the superior mesenteric artery dissection, confirm the diagnosis, and provide an important basis for the classification and follow-up observation.