主动脉壁间血肿的64排多层螺旋CT血管成像

目的探讨64排多层螺旋CT(MSCT)血管成像对主动脉壁间血肿(AIH)的诊断价值。方法对64排MSCT诊断、并经临床/或DSA证实的13例AIH病例进行回顾性分析,分析AIH64排MSCT表现特点。结果 13例AIH中,64排MSCT轴面平扫4例主动脉壁呈新月型增厚,9例环形增厚,其中7例增厚动脉壁密度不均,可见内膜钙化并钙化片内移;CT增强所有病例动脉管腔直径变小,均未发现内膜撕裂破口,增厚主动脉壁不强化。结合三维重建后表现,本组病例按Stanford法分型,B型12例,A型1例。9例合并胸腔积液、2例合并心包积液。结论 64排MSCT平扫和增强可以反映AIH的特点,并能准确区分主动脉夹层与AIH,为临床诊断提供可靠依据。

64 Slice MSCT in Aortic Intramural Hematoma

Objective To discuss the application and values of MSCT （multiple -slice spiral computed tomography） in AIH （aortic intramural hematoma） diagnosis. Methods Through a review of 13 AIH cases diagnosed by MSCT and confirmed by clinical observation and/ or DSA, analysis the performance and features of MSCT in AIH. Results Among the above 13 AIH cases, the axial plain scan showed that 4 cases were found a crescent incrassation on the aortic wails and 9 cases a ring-like incrassation, with 7 of the 9 cases seeing an uneven density on the walls. Moreover, calcification was also observed on the intima of those 7 cases, and the calcific slices moves. CT enhancement showed the signs of narrowed aortic lumen diameters in all cases; however, it did not enhance the incrassate aortic walls. Accord- ing to the above findings and a 3D reconstruction, and based on the Stanli）rd method, those 13 cases were categorized into two types, with l 2 B cases, and 1 A cases, 9 cases merged the pleural effusion, and 2 cases merged the pericardial effusion. Conclusion The plain and enhancement scan of MSCT can show the features of AIH,and accurately distinguish Ihe difference between AD and AIH, MSCT has a high diagnostic value for A1H.