主动脉病变腔内隔绝术后多层螺旋CT血管造影的应用价值

目的探讨多层螺旋CT血管造影(MSCTA)在主动脉病变腔内隔绝术后的应用价值。方法15例主动脉夹层及4例腹主动脉瘤患者腔内隔绝术后行16层螺旋CT血管造影检查,准直器宽度0.75mm,床进15mm/圈,由两名观察者分析图像,判断术后主动脉夹层及主动脉瘤的转归情况以及并发症的产生。结果19例患者的主动脉夹层假腔或腹主动脉瘤支架外瘤体内均有血栓形成,但1例腹主动脉瘤支架内膜下血栓形成,腹主动脉瘤瘤体均较术前缩小;4例出现内漏,其中Ⅰ型内漏3例,Ⅲ型内漏1例并合并支架变形;1例右肾恢复灌注;1例肠系膜上动脉血栓溶解。结论MSCTA以其无创、快速等优点已成为主动脉病变腔内治疗术后复查的首选影像学检查方法,结合多种后处理方法能对主动脉病变腔内隔绝术的疗效做出较为客观的评价。

Application of multi-slice spiral CT angiography after endoluminal exclusion of aortic diseases

OBJECTIVE: To study the application of multi-slice spiral CT angiography (MSCTA) after endoluminal exclusion of aortic diseases. METHODS: 16-slice CT angiography was performed in 15 patients with aortic dissection and 4 patients with aortic aneurysm after endovascular exclusion. Two observers analysed the images and interpreted the outcomes and complications after endovascular exclusions of aortic dissection and aortic aneurysm. RESULTS: In 19 patients, thrombus was found in all the false lumens of aortic dissection and the outer-stent cavity of aortic aneurysm. However, one patient with aortic aneurysm graft thrombosis; 4 patients had endo-leak (3 with type I endo-leak, 1 with type III endo-leak complicating graft deformation); one achieved perfusion recovery, and one experienced thrombolysis of superior mesenteric artery. CONCLUSION: MSCTA can be an objective tool for the post-operative evaluation of endovascular exclusion of aortic diseases.