假性动脉瘤的影像诊断及介入治疗

目的 研究假性动脉瘤的影像诊断及介入治疗的价值。方法 分析24例假性动脉瘤的影像学表现和介入治疗方法。结果 数字减影血管造影（Digital substraction angiography,DSA)显示损伤动脉管壁破裂，管腔外形成囊腔，超声显示血管周围有无回声区或混合性回声区，破裂处可探及连续性血流频谱，CT增强见中心部分呈高密度影，边缘部分环状强化，血栓部分不强化，MRIT1WI示瘤腔呈低信号，血栓呈等，低混合信号，T2WI示瘤腔呈低信号，血栓呈高信号，13例栓塞者见损伤动脉闭塞，1例使用支架结合暂时球囊闭塞瘘口获得成功，另外10例经外科手术治愈。结论 外伤性动脉瘤的影像诊断中DSA检查定性定位最准确。介入治疗是假性动脉瘤的重要治疗方法，尤其在病情危重，急诊情况下有着积极意义。

Imaging diagnosis and interventional treatment of pseudoaneurysm

objective To evaluate imaging diagnosis and interventional therapy for pseudoaneurysms. Methods Imaging appearances and therapy of 24 cases of pseudoaneurysms were retrospectively analyzed. Results (Digital substraction angiography,DSA) showed the rupture of traumatic arteries and the formation of the cysts. Ultrasonography showed echo free areas or echo-compound areas and continuous doppler spectrum in rupture. The dynamical computerized tomography(CT) scan revealed that the center of pseudoaneurysms was higher density. There was ring shaped enhancement in its edge and no enhancement in thrombus. In magnetic resonance imaging (MRI), pseudoaneurysms were low intensity in T 1WI and T 2WI, the thrombus were low intensity in T1WI and high intensity in T 2WI. Transcatheter arterial embolization achieved control of bleeding in 13 cases. One case was successfully treated with stent and temporal balloon embolization of fistulas. The rest 10 cases were treated with operation. Conclusion DSA is the best method in pseudoaneurysms diagnostic imaging. Interventional treatment is the important therapeutic method for pseudoaneurysm, especially for serious and emergent patients.