穿透性粥样硬化性主动脉溃疡的MSCTA表现

目的 探讨穿透性粥样硬化性主动脉溃疡（PAU）的多层螺旋CT血管造影（MSCTA）表现,进一步提高对本病的认识. 资料与方法 搜集我院行MSCTA的PAU15例,以横轴位CT为主,结合二维及三维重组对PAU的部位,大小及合并征象进行分析. 结果 15例共17个病灶.均表现为主动脉壁上的溃疡状突起,龛影口部与主动脉腔相连,可表现＂狭颈征＂,尤其在曲面重组（CPR）图像上明显.伴有局部或弥漫性主动脉壁内血肿（IMH）.间接征象包括主动脉壁钙化斑块、主动脉扩张等. 结论 MSCTA上主动脉溃疡伴随局限或广泛的IMH者均可诊断为PAU,MSCTA为诊断PAU的有力工具,诊断应以薄层横轴位和CPR图像为主,容积再现（VR）图像为辅.

The MSCTA Features in Penetrating Atherosclerotic Aortic Ulcerres

Objective To discuss the manifestation of PAU on MSCTA in order to acknowledge the disease deeply. Materials and Methods 15 patients of PAU were collected, the location, size and complications of PAU were analyzed on axial and 2D/3D images. Results 17 lesions were found in 15 patients. Ulcer-like aortic projections were observed, and connected with aortic cavity, where "narrow neck sign" was shown., especially obviously on CPR images,and localized or extensive IMH were observed too. The indirect signs included calcification of aortic wall and dilatation of aorta. Conclusion Aortic ulcer accompanied by localized or extensive IMH can be diagnosed as PAU and MSCTA is a useful technique, the diagnosis depends on axial and CPR images, and VRT is a complementary method.