主动脉壁内血肿的多层螺旋CT诊断

目的：探讨主动脉壁内血肿（intramural hematoma，IMH）的多层螺旋CT（MSCT）影像特征及其对临床诊治的指导意义。方法：35例经MSCT增强扫描的主动脉IMH患者，综合分析其CT影像特征及临床特点。结果：MSCT所见IMH的直接征象：35例主动脉壁均可见不同厚度的新月形或环形低密度增厚，无内膜片及真、假腔：间接征象：穿透性溃疡征18例、钙化内移7例、主动脉壁粥样硬化16例、一侧或双侧胸腔积液21例（15例同时合并叶间裂或心包积液）：并发征象：动脉瘤5例、B型主动脉夹层3例。结论：MSCT是检出主动脉IMH的快速、无创检查方法，可清晰显示IMH的直接、间接征象及并发征象，对临床的诊治有重要的指导意义。

Diagnosis of Aortic Artery Intramural Hematoma Using Multi-Slice Spiral Computed Tomagraphy

Objective To investigate the CT findings and guidance significance of multi-slice computed tomography（MSCT） in aortic intramural hematoma （IMH）. Methods The clinical data and MSCT findings of 35 cases of aortic intramural hematomas diagnosed by MSCT with continuous volume scanning were analyzed. Results The direct signs of IMH were crescent or circular thickening of aortic wall without intimal flap and true and false lumens in all 35 patients. The indirect signs were penetrating ulcer（ 18 cases）, calcification ingression （7 cases）,atherosclerosis （16 cases）and single or bilateral pleural effusion（21 cases）. The complicated signs were aneurysms （5 cases） and typical type B aortic dissection （3 case）. Conclusion MSCT is a fast and noninvasive examinational technique, by which the direct, indirect and complicated signs of aortic IMH can be clearly revealed. All these signs have important guidance values for clinical diagnosis and management.