急性主动脉综合征急诊CT诊断价值.docVIP

急性主动脉综合征急诊CT诊断价值 　　[摘要] 目的 探讨急诊CT对急性主动脉综合征的诊断价值。 方法 回顾性分析该院2015年11月―2017年1月20例以突发急性胸痛行急诊CT检查诊断为急性主动脉综合征病变的临床及影像学资料。结果 20例患者均行CT平扫，8例同时行CT增强扫描。20例中主动脉夹层14例（Sandford A型10例，B型4例），CT平扫可见主动脉增宽、内膜钙化斑移位及线样征，增强可见双腔征和撕脱内膜片；壁内血肿4例，表现为沿主动脉壁新月形或环形高密度，增强无强化；穿透性粥样硬化性溃疡2例，CT增强见主动脉壁内有对比剂充盈的龛影。伴胸腔积液7例、伴心包积液或积血4例。结论 急诊CT可显示主动脉综合征的直接和间接影像征象，对诊断、鉴别诊断及预后评估具有重要价值 [关键词] 急性主动脉综合征；主动脉夹层；壁内血肿；穿透性动脉硬化性溃疡；急诊CT [中图分类号] R816.2 [文献标识码] A [文章编号] 1674-0742（2017）04（a）-0190-04 Emergency CT Diagnosis Value of Acute Aortic Syndrome LIU Jie1， DING Chang-qing2， YU Lei2， WANG Feng1 1.Department of Cardiology， Fengxian Peoples Hospital， Fengxian， Jiangsu Province， 221700 China；2.Department of Imaging， Fengxian Peoples Hospital， Fengxian， Jiangsu Province， 221700 China [Abstract] Objective To study the emergency CT diagnosis value of acute aortic syndrome. Methods The clinical and imaging data of 20 cases of patients with acute aortic syndrome through the emergency CT examination due to the acute chest pain in our hospital from November 2015 to January 2017 were retrospectively analyzed. Results 20 cases underwent the CT plain scanning， and 8 cases underwent the CT enhancement scanning， 14 cases were with aortic dissecting aneurysm （10 cases of Sandford A type and 4 cases of Sandford B type）， and CT plain scanning showed the aortic broadening， displacement of intimal calcification and avulsion intimal flap， 4 cases were with intramural hematoma， showing the aortic intramural crescent-shape or ring high density， and the enhancement had no reinforcement， 2 cases were with penetrating atherosclerotic ulcer， 7 cases were with pleural effusion and 4 cases were with pericardial effusion or hemorrhage. Conclusion The emergency CT can show the direct and indirect imaging features of aortic syndrome， which is of important value to the diagnosis， differential diagnosis and prognosis evaluation. [Key words] Acute aortic syndrome； Aortic dissecting aneurysm； Intramural hematoma； Penetrating atherosc