医学影像诊断学02心脏大血管.ppt

Signs of imaging X-ray Widened mediastinum, Abnormal (ie, blunted) aortic knob Aortic pulsation ↓/ disappear Ring sign (displacement of the aorta 5 mm past the calcified aortic intima) a very specific radiographic sign Other signs: pleural effusion; LV↑ ---------Aortic dissection Figure 1. Chest radiograph of a patient with aortic dissection. ---------Aortic dissection Figure 2. Chest radiograph of a patient with aortic dissection presenting with hemothorax. ---------Aortic dissection Figure 3. Chest radiograph demonstrating widened mediastinum in a patient with aortic dissection. ---------Aortic dissection Cardioangiography Thoracic aortic angiography Visualization of the true and false lumens intimal flap aortic regurgitation stenosis/ obstruction of coronary arteries ---------Aortic dissection Figure 4. Angiogram demonstrating dissection of the aorta (same patient as in Image 3). ---------Aortic dissection Angiogram demonstrating dissection of the aorta USG CT Contrast enhancement CT scan With the advent of helical CT with multiplanar and 3D reconstruction, CT is quickly replacing the angiogram as the criterion in many institutions. ---------Aortic dissection Figure 5. Patient with an ascending Type I aortic dissection showing the intimal flap. ---------Aortic dissection Figure 6. Patient with a Type I aortic dissection involving the ascending and descending aorta. ---------Aortic dissection Figure 7. Patient showing a Type II aortic dissection with extravasation of blood into the pleural cavity. ---------Aortic dissection CT Diagnosis of Aortic dissection (DeBakay type III ) MRI Without Contrast enhancement ：MR cine Contrast enhancement MRA（CE-MRA） ---------Aortic dissection MRI Diagnosis of Aortic dissection (DeBakay type I ) MRI Diagnosis of Aortic dissection (DeBakay type III ) CAG Diagnosis and therapy of Aortic dissection Diagnosis and differential diagnosis ---------Aortic dissection Thank you ! *