双源CT对主动脉壁内血肿影像诊断

目的：评价双源CT（DSCT）诊断主动脉壁内血肿的价值。方法：采用西门子DSCT扫描机，连续容积增强扫描，对25例主诉急性胸背痛患者进行DSCT检查并诊断为主动脉壁内血肿。结果：25例按Stanford分型：A型7例，B型18例。DSCT所见主动脉壁内血肿的直接征象：主动脉壁呈新月形或环形增厚≥5mm，无内膜破裂形成的主动脉征象。间接征象：钙化内移7例，穿透性溃疡征12例，主动脉壁粥样硬化改变18例，内膜渗漏5例。并发征象：心包积液5例，胸腔积液14例，主要分支血管受累5例，主动脉夹层3例，主动脉瘤4例。结论：DSCT能为主动脉壁内血肿的诊断和治疗提供重要信息，且便于治疗后随诊观察。

Diagnosis of aortic intramural hematoma by dual-source CT

Objective：To assess the value of dual-source CT （DSCT） in the diagnosis of aortic intramural hem atoma （AIH）. Methods：Twenty-five patients wbo complained of acute chest and back pain were scanned wlda an DSCT scanner （Definition） using contrastenhanced continuous volumes canning （CVS） for establishing the diagnosis of AIH. Results： Seven patients were diagnosed as Stanford type A, and the others as type B AIH. The direct features of AIH in DSCT included crescent or circular thickening （ 〉 5mm） of the aortic wall without signs of lumen formation resulting from intimal rupture. The indirect feature included calcification ingression （7 eases）, penetrating ulcer （ 12 cases）, atherosclerosis （18 cases）, and leakages （5 eases）. The complicating features included perieardial effusion （5 cases）, pleural effusion （14 cases）, involvement of the large branches （5 cases）, aortic dissection （3 cases）, and aneurysms （4 eases）. Conclusion： DSCT can provide important information for the diagnosis and treatment of AIH, and can be useful for follow-up observation of the patients.