冠状动脉介入治疗术中冠状动脉壁内血肿的血管内超声评价

任书堂; 李予昕; 刘晓程; 黄云洲; 齐滕颖

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中国临床医学影像杂志 ›› 2007, Vol. 18 ›› Issue (9) : 619-620.

论著

冠状动脉介入治疗术中冠状动脉壁内血肿的血管内超声评价

任书堂1，李予昕2，刘晓程1，黄云洲1，齐滕颖2

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Intravascular ultrasonic diagnosis of coronary artery intramural hematomasduring percutaneous coronary interventions

REN Shu-tang1, LI Yu-xin2, LIU Xiao-cheng1, HUANG Yun-zhou1, SATOSHI Saito2

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摘要

目的：探讨血管内超声（IVUS）评价冠状动脉介入治疗术中冠状动脉壁内血肿的价值。方法：对17例经血管内超声诊断为冠状动脉壁内血肿的患者进行回顾和总结，分析其血管横断面及长轴观的影像学特征。结果：IVUS显示冠状动脉壁内血肿的短轴观呈新月形或环形，呈等于或稍强于血液的斑点状回声，长轴观显示为中膜内或中膜与外膜之间长度不等的占位，形态或直或扭曲，呈接近血液回声或稍强回声。血肿压迫血管腔可形成不同程度梗阻。结论：血管内超声是诊断冠状动脉壁内血肿或出血的准确、直观的方法，可清晰显示壁内血肿的空间方位及形态特征，对临床诊治具有指导意义。

Abstract

Objective: To explore the value of intravascular ultrasound(IVUS) in diagnosing coronary artery intramural hematomas（IMH） during percutaneous coronary interventions． Methods: The IVUS findings in 17 cases of coronary artery IMH were analysed． Results: IVUS revealed that the cross-section views of coronary artery IMH appeared as a homogeneous, hyperechoic, crescent-shaped or circular area within media or between media or EEM, and the long axis views of IMH presented unbent or tortuous homogeneous space-occupying lesions with varied length. IVUS showed hyperechoic or equal echogenic of the hematoma． The obstruction was caused by an extraluminal echolucent or echo-dense mass encroaching the vessel lumen, and without a dissection flap． Conclusion: IVUS is an accurate and direct examination technique, with which the location and shape of post-angioplasty coronary artery IMH can be clearly shown． All these signs have important value for clinical diagnosis and treatment．

导出引用

任书堂;李予昕;刘晓程;黄云洲;齐滕颖. 冠状动脉介入治疗术中冠状动脉壁内血肿的血管内超声评价[J]. 中国临床医学影像杂志. 2007, 18(9): 619-620

REN Shu-tang;LI Yu-xin;LIU Xiao-cheng;HUANG Yun-zhou;SATOSHI Saito. Intravascular ultrasonic diagnosis of coronary artery intramural hematomasduring percutaneous coronary interventions[J]. Journal of China Clinic Medical Imaging. 2007, 18(9): 619-620

中图分类号： Ｒ541.4 Ｒ814.43 Ｒ445.1