摘要
目的：探讨主动脉壁内血肿（IAH）的16层螺旋CT检查方法，分析其多层螺旋CT表现及鉴别诊断意义。材料与方法：22例主动脉急症患者行16层螺旋CT平扫与增强扫描并诊断为IAH。使用16层CT获得层厚1.25mm的图像，重组方法包括多平面重组、曲面重组、最大密度投影和容积再现。结果：22例IAH中，A型1例，B型21例。6例IAH伴主动脉穿透性溃疡，11例有动脉粥样硬化，5例合并动脉瘤。结论：IAH的16层螺旋CT检查应包括平扫与双期增强扫描，图像观察以轴面为主。IAH主要CT表现为平扫时管壁内新月形高或混杂高密度影及内膜钙化移位，增强扫描无强化及无内膜片。IAH可合并主动脉其他病变，根据上述征象可与其他主动脉急症鉴别。
Abstract
Objective: To explore the CT examination technique and manifestations of intramural aortic hematoma(IAH) and determine the diagnostic value of 16-slice spiral CT for IAH. Materials and Methods: Twenty-two patients who suspected of aortic emergency were refered to our department. The 1.25mm slice thickness were used to reconstruct images for post-processing using 16-slice spiral CT. The multiplanar reconstruction(MPR), curved planar reconstruction(CPR), maximum intensity projection(MIP) and volume rendering(VR) were used. Results: Twenty-one of the 22 IAH were type B, which the descending aorta was involved in 5 cases, thoracic and abdominal aorta were involved in 15 cases and 2 cases located in abdominal aorta. Six cases were accompanied by penetrating atherosclerotic ulcer, 11 cases had atherosclerosis, and 5 cases had aortic aneurysms. Conclusion: For evaluating IAH with 16-slice spiral CT, plain scan and bi-phase postcontrast imaging of the entire aorta should be made. Axial image is the main source of diagnostic information. On non-contrast examination, the important signs of IAH include crescent-shaped hyperdensity or heterogeneous hyperattenuation lesions within the wall and calcified intima shift endocentrically. There is no enhancement and intimal flap after contrast medium injection. Other aortic diseases such as penetrating ulcer could be found in IAH cases. Based on the above mentioned findings, IAH could be differentiated from other acute aortic diseases.
关键词
血肿 /
主动脉 /
体层摄影术 /
螺旋计算机
Key words
Hematoma /
Aorta /
Tomography /
spiral computed
袁 涛;全冠民;尚 华;雷建明.
主动脉壁内血肿的16层螺旋CT检查评价[J]. 中国临床医学影像杂志. 2008, 19(5): 305-308
YUAN Tao;QUAN Guan-min;SHANG Hua;LEI Jian-ming.
Intramural aortic hematoma: evaluated with 16-slice spiral CT[J]. Journal of China Clinic Medical Imaging. 2008, 19(5): 305-308
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