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Atypical aortic dissection (intramural hematoma) of aorta: diagnosis of electron beam computer tomography
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 10
- DOI:
- 10.3760/j.issn:1005-1201.2001.10.004
- Key Word:
- 主动脉,夹层;体层摄影术,X线计算机
Abstract： 目的评价电子束CT(EBCT)在主动脉不典型夹层诊断中的临床应用.方法 1994年5月至2000年4月15000例EBCT检查中诊断主动脉夹层263例,其中25例为不典型夹层.男21例,女4例.全部患者均以主诉急性胸痛入院检查.采用Imatrorn 150-XP型EBCT扫描机,连续容积增强扫描,层厚3 mm,扫描时间为0.1 s.扫描范围自主动脉弓水平至左右髂动脉分叉处,共140层.结果不典型夹层EBCT血管造影(EBCTA):直接征象为:(1)25例主动脉壁均呈半月状或环状增厚,达5～23 mm,平均15.3mm,无内膜破裂形成的双腔主动脉征象,CT值50～87 HU,累及长度为2.5～49.0 cm,平均16.3 cm;(2)内膜钙化移位5例;(3)6例治疗后EBCT随访,管壁厚度呈动态变化.间接征象为:(1)主动脉壁增厚溃疡形成7例;(2)动脉粥样硬化性改变12例.上述征象结合临床急性胸痛病史,诊断可以成立.病变累及升主动脉(Stanford A型)6例;仅累及降主动脉(Stanford B型)19例.全部病例临床均采取保守治疗,其中6例EBCT复查,3个月至1年血肿吸收.结论急诊胸痛鉴别诊断中EBCT对主动脉不典型夹层诊断是一种无创、安全、有效的诊断方法,且便于治疗后随诊观察.
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