胸部急症CT诊断课件.pptVIP

女，59岁 2013-10-09 肺动脉内多发充盈缺损 2013-10-09 右心室、房内充盈缺损，粘液栓？ 2013-10-09 Left Right 2013-10-09 2013-10-09 希望有所收获 * * * * * 男，57岁 发作性心慌、胸闷2月余 术前CT（上组图）示升主动脉瘤样扩张，主动脉瓣增厚 术后CT（下组图）示升主动脉部分人工血管置换，主动脉瓣置换。 2013-10-09 男，43岁。突发胸背痛7天。主动脉弓降部真性动脉瘤形成。 2013-10-09 2013-10-09 男，34岁。活动后胸背部疼痛7天。CT示主动脉弓降部假性动脉瘤形成。 胸主动脉瘤（男，76岁，以纵隔占位就诊） 2013-10-09 2013-10-09 2013-10-09 胸主动脉瘤（男，69岁） 2013-10-09 2013-10-09 2013-10-09 男，40岁，主动脉瓣置换病史 2013-10-09 2013-10-09 男，22岁 2013-10-09 2013-10-09 2013-10-09 2013-10-09 主动脉夹层 主动脉夹层指主动脉腔内的血液通过内膜的破口进入主动脉壁中层而形成的壁内血肿，并非主动脉壁的扩张 危险因素 Common predisposing factors in the International Registry of Aortic Dissection (IRAD) were hypertension in 72% of cases, followed by atherosclerosis in 31% and previous cardiac surgery in 18% 国际主动脉夹层官方记录（IRAD）显示，最常见的危险因素为高血压，占病例的72％；其次为动脉粥样硬化，占31％；心脏手术史，占18％ Analysis of the young patients with dissection (,40 years of age) revealed that younger patients were less likely to have a history of hypertension (34%) or atherosclerosis (1%), but were more likely to have Marfan syndrome, bicuspid aortic valve, and/or prior aortic surgery 针对年轻患者的分析显示年轻患者（40岁）较少有高血压病史（占34％）及动脉粥样硬化史（1％），而马凡氏综合征史、主动脉瓣双瓣畸形和（或）主动脉手术史可能性更大 2013-10-09 分型 DeBakey Stanford 2013-10-09 胸主动脉解剖 2013-10-09 Anatomy of the thoracic aorta and significant landmarks. The ascending aorta extends from the aortic valve to the origin of the innominate artery. Its proximal portion, in relation to the aortic valve and sinuses of Valsalva, is termed the aortic root. The aortic arch begins at the innominate artery and ends at the ligamentum arteriosum. Its most distal part, which is often slightly narrowed, is termed the aortic isthmus. The descending aorta begins at the ligamentum. Its proximal portion may appear slightly dilated and has been termed the aortic spindle. 2013-10-09 男，30岁，突发剧烈胸痛就诊 主动脉边缘毛糙 DeBakey Ⅰ型，伴左肾梗死 2013-10-09 2013-10-09 男，28岁，突发剧烈胸痛就诊 2013-10-09 2013-10-09 心电门控扫描，DeBakey Ⅰ型，累及右侧冠状动脉起始部 斜矢状图像 2013-10-09 VR图清晰显示假腔范围，并发峡部囊状动脉瘤 2013-10-09 女，49岁，降主动脉支架置入病史 2013-10-09