主动脉壁内血肿的16层CT诊断

目的：探讨16层螺旋CT对主动脉壁内血肿（IMH）的诊断价值。方法：42例患者以急性主动脉综合征就诊；3例患者以慢性病史就诊，CT增强检查使用对比剂示踪技术，运用多平面重建、最大密度投影、容积重建、仿真内镜等重建方法，结合轴位图像，分析45例IMH的部位、形态、有无溃疡及胸腔积液等。结果：单纯性IMH9例，表现为沿主动脉壁的环状或新月形稍高密度影，增强后没有强化，主动脉内壁光滑；渍疡性IMH36例，溃疡呈乳头状16例，蘑菇状8例，楔形2例，不规则型7例，花瓣状3例。24例溃疡周围有较明显粥样斑块和钙化灶，12例无粥样斑块和钙化灶。9例IMH仅1例有少量胸腔积液，30例溃疡性IMH合并中量以上胸腔积液，单纯性和溃疡性IMH胸腔积液的程度和出现率比较，差异有统计学意义。结论：16层螺旋CT能够反映IMH影像学特点，可作为急诊首选检查方法。

Application of 16-slice Spiral CT in the Diagnosis of Aortic Intramural Hematoma

Objective:To investigate the value of 16-slice spiral CT in the diagnosis of intramural hematoma (IMH) of aorta.Methods:42 patients with acute aortic syndromes,3 patients with other chronic diseases underwent 16-slice spiral CT.Contrast enhanced images were generated with bolus tracking technique for vascular assessment,post-processing technique included multi-planar reformation (MPR),maximum intensity projection (MIP),volume rendering (VR),CT virtual endoscopy (CTVE) in combination with axial images were u...