37例钝性胸主动脉损伤CT血管造影征象的回顾性分析

目的 回顾性分析钝性胸主动脉损伤的CT血管造影(CTA)征象,为CTA诊断钝性胸主动脉损伤积累经验.方法 对2004年6月至2014年6月在解放军总医院急诊科诊治的37例经手术或主动脉造影证实的钝性胸主动脉损伤患者CTA图像进行回顾性分析,总结钝性胸主动脉损伤CTA的征象特点.结果 37例钝性胸主动脉损伤部位分别为主动脉峡部83.8％ (31/37)、主动脉弓5.4％ (2/37)、主动脉降部8.1％ (3/37)、主动脉升部2.7％ (1/37).钝性胸主动脉损伤CTA征象表现为内膜瓣34例(91.8％),主动脉轮廓改变或腔异常37例(100％),动脉收缩17例(45.9％),主动脉夹层10例(27.0％),假性动脉瘤21例(56.7％),血栓1例(2.7％).结论 CTA征象是诊断钝性胸主动脉损伤的重要依据,具有定性诊断价值.

CTA signs for blunt thoracic aortic injury: a review of 37 cases

Objective To review computed tomographic angiography (CTA) signs and its potential use in the diagnose of blunt thoracic aortic injury Methods We reviewed 37 cases with blunt thoracic aortic injury (TAI) confirmed by surgery or aortography in Chinese PLA General Hospital emergency department from June 2004 to June 2014.CTA were performed on these patients,and CTA images were analyzed retrospectively to obtain characteristic CTA signs of blunt thoracic aortic injury.Results Of the 37 cases,the blunt injury in aortic isthmus were 83.8％ (31/37),aortic arch 5.4％ (2/37),descending aorta 8.1％ (3/37),and ascending aorta 2.7％ (1/37),respectively.CTA signs of thoracic aortic injury manifested as intimal flap in 34 patients (91.8％),abnormal aortic contour or cavity in 37 cases (100％),arterial contraction in 17 cases (45.9％),aortic dissection in 10 cases (27.0％),pseudoaneurysm in 21 cases (56.7％),thrombosis in 1 case (2.7％).Conclusions CTA signs could be used to facilitate the diagnosis of blunt thoracic aortic injury with a qualitative diagnostic value.