64层螺旋CT对主动脉夹层的应用价值

目的:探讨64层螺旋CT诊断主动脉夹层的临床价值。方法:39例拟诊为主动脉病变的患者作为本组研究对象,对所有患者行CT平扫及增强扫描。CT平扫图像上观察内膜钙化的移位、主动脉直径扩大、心包和/或纵隔积血、胸腔积液/血。并对A型和B型主动脉夹层的平扫征象进行统计学比较。CT增强图像上观察低密度的内膜瓣、破口(入口和再入口)、真假腔及主要动脉分支受累情况。结果:21例主动脉夹层中,CT平扫观察到钙化的内膜瓣移位9例(42.9%),主动脉直径增宽8例(38.1%),心包和/或纵隔积血8例(38.1%),胸腔积液/血5例(19.0%)。CT增强扫描对主动脉夹层内膜瓣的显示率达100%(21/21),对真、假腔的显示率为100%(21/21),对破口的显示率为85.7%(18/21)。8例(38.1%)弓上血管受累,5例(19.0%)内脏血管受累。结论:64层螺旋CT对主动脉夹层有较高的诊断价值,能较好的显示夹层的真假腔、内膜瓣及破口,并且可以显示主要动脉受累情况,为外科的手术治疗提供重要信息。

The application of 64 slice multi-detector CT in aortic dissection

Objective:To investigate the value of 64 slice multi-detector CT in diagnosing aortic dissections.Methods:Thirty-nine patients with suspect aortic diseases were evaluated in this study with Siemens 64 slices CT scanner.All of the patients were performed with non-contrast and contrast scans.The presence of intimal calcifications of displaced towards the aortic lumen,an aorta with an enlarged diameter,hemopericardium or hemomediastinum,pleural effusion were observed on non-contrast scans.The appearance of A and B type aortic dissection on non-contrast images were compared.The low-density intimal flap,the entrance and re-entrance,the true channel and false channel,the involvement of collateral branches of the aorta were observed on contrast images.Results:Intimal calcifications of displaced towards the aortic lumen were showed in 9 cases(42.9%) on non-contrast images,an aorta with an enlarged diameter in 8 cases(38.1%),hemopericardium or hemomediastinum in 8 cases(38.1%),pleural effusion in 5 cases(19.0%).On contrast images,the demonstration rate of initial flap,the true channel and false channel,and tear entrance were 100%(21/21),100%(21/21),and 85.7%(18/21) respectively.There were 8 cases(38.1%) with the supra-aortic arteries involved,5 cases(19.0%) with the abdominal visceral branches involved.Conclusion:The 64 slice multi-detector CT are help to the diagnosis of aortic dissections.The intimal flap,the true and false channel and the tear entrance can be displayed well,as well as the supra-aortic arteries and the the abdominal visceral branches involved.