主动脉壁内血肿CT血管成像.docVIP

主动脉壁内血肿的CT血管成像 发表时间：2010-2-24 11:05:04 来源：创新医学网推荐 作者：李宝新 金东升??? 作者单位：210008江苏省南京市，南京大学医学院附属鼓楼医院放射科（李宝新）；210024江苏省南京市，江苏省省级机关医院放射科（金东升） 【摘要】? 目的 评价多层螺旋CT血管成像对主动脉壁内血肿的诊断价值。 方法 对临床怀疑的186例夹层动脉瘤行多层多排螺旋CT扫描，其中确诊夹层动脉瘤105例，主动脉壁内血肿23例，采用多平面重建（MPR），曲面重建（CPR），最大密度投影（MIP）等方法显示壁内血肿及血管壁溃疡并按Stanford分型。 结果 23例主动脉壁内血肿，6例为A型，17例为B 型。CT主要表现为：（1）所有病例见主动脉壁呈新月形或环形增厚，其中增厚的壁≥5 mm；（2）5例见主动脉内壁上有溃疡形成；（3）5例并发胸腔及心包积液。在MPR，CPR及MIP上均可清楚显示血肿的部位、累及范围、血肿程度以及并发症。 结论 16层螺旋CT对主动脉壁内血肿具有重要的诊断及临床应用价值。 【关键词】? 主动脉； 壁内血肿； 多层螺旋CT血管成像； 血管造影 ?????????? Clinical application of 16slice spiral CT angiography in aortic intramural hematoma? LI Baoxin. Department of Radiology, the Affiliated Drum Hospital, Medical college of Nanjing University, Nanjing 210008, China; JIN Dongshen. Department of Radiology, Jiangsu Province Official Hospital, Nanjing 210024,China 　【Ａｂｓｔｒａｃｔ】　Ｏｂｊｅｃｔｉｖｅ? To evaluate the value of multislice spiral CT angiography in aortic intramural hematoma (AIH).? Ｍｅｔｈｏｄｓ? One hundred and eightysix patients who were suspected of aortic dissection had taken 16slice spiral CT examination. 105 cases of aortic dissection and 23 cases of aortic intramural hematoma(AIH) were diagnosed with different postprocessing techniques such as multiplanar reformation (MPR), curvedplanar reformation (CPR), maximum intensity projection (MIP). AIHs were classified according to Stanford standard classification.? Ｒｅｓｕｌｔｓ? Among 23 cases of AIH, 6 cases showed type A, 17 type B. MSCTA showed the crescent or circular filling defected I aortic cavities. with aortic walls≥5 mm. Five cases presented the formation of local sharpangled penetrating ulcers but did not show definite intramural piece in aortic cavities. Another 5 cases had pleural effusion and pericardiac effusion. On MPR and CPR,MIP imaging clearly displayed the sites, thickness, extension and complication of the AIH.? Ｃｏｎｃｌｕｓｉｏｎｓ? 16 slice spiral CT can provide important information for the diagnosis of aortic intramural hematoma.??? 　　【Key　ｗｏｒｄｓ】? ao