主动脉夹层CTA的诊断及介入治疗

目的对主动脉夹层CTA的诊断及介入治疗进行探讨与分析。方法本研究共纳入研究对象60例,均为2012年6月到2014年1月我院收治的主动脉夹层患者,所有患者均经DSA抑或MR T1-FS确诊。对患者的内膜瓣、管壁增厚、夹层动脉瘤和双腔征等影像学征象进行回顾性分析。结果 60例患者中出现主动脉夹层病变的70处,其中30例前循环,40例后循环。在70处主动脉夹层病变当中,有27处内膜瓣,7处双腔征,36处血管狭窄。相比DSA诊断,通过CTA可以把23处内膜瓣显示出来,占85.2%(23/27),可把5处双腔征显示出来,占71.4%(5/7),可把34处血管狭窄显示出来,占94.4%(34/36)。而在显示主动脉夹层脉瘤和血管闭塞上差异不显著。CTA比MR T1-FS更容易把血管内膜增厚给显示出来。结论通过CTA诊断主动脉夹层,能够把多种影像学征象给清晰显示出来,包括管壁和血管腔在内的主动脉夹层,是一种有效的影像学方式,对临床上运用适当的介入治疗有着重要的指导作用。

Study on computed tomography angiography in diagnosis and interventional treatment of aortic dissection

Objective To discuss and analyze computed tomography angiography （CTA） in the diagnosis and interventional treatment of aortic dissection. Methods Sixty patients with aortic dissection admitted to our hospital from June 2012 to January 2014 were enrolled in this study. All cases were confirmed by digital subtraction angiography （DSA） or MR T1-FS. The imaging findings of intimal flap, wall thickening, dissecting aneurysm, and double-lumen sign of the patients were analyzed retrospectively. Results Among 70 aortic dissection lesions in 60 patients, 30 were anterior circulation ones, and 40 were posterior circulation ones;27 cases had intimal flap, 7 had double-lumen sign, and 36 had vascular stenosis. Compared with DSA, CTA showed 23 cases with intimal flap, accounting for 85.2% （23/27）, 5 cases with double-lumen sign, accounting for 71.4% （5/7）, and 34 cases with vascular stenosis, accounting for 94.4%（34/36）. The two examinations showed no significant differences in showing aortic dissection and vessel occlusion. Compared with MR T1-FS, CTA showed intimal thickening more easily. Conclusion For the diagnosis of aortic dissection, CTA can clearly show various imaging signs including aortic dissection in the vessel wall and lumen. It is an effective imaging method which can provide guidance for clinical interventional treatment.