主动脉根部3D及4D成像教学案例.pptVIP

Lets briefly review the surgical terminology of thoracic aortic anatomy the descending thoracic aorta is the segment distal to the left subclavian artery takeoff. The transverse aorta, or the aortic arch refers to the segment immediately proximal to the right brachicephalic and including the subclavian takeoff. By the term ascending aorta, the surgens usually refer to the tubular portion of the ascending aorta, that is the segment between the sinotubular ridge and the arch. And the most proximal portion of the thoracic aorta is called the aortic root the aortic root consists of the following structures - the aortic anulus, which is the junction between the left ventricle and the aorta - then there are three sinuses of Valsalve. The sinuses contain the aortic valve apparatus, and the right and left coronary artery also arise from the respective sinuses. - and finally there is the sinotubular junction, which is usually a small waist or ridge between the aortic root and the tubular portion of the ascending aorta. here we see the same anatomy on a CT angiogram of a patient with an ascending aortic aneurysm, and these thin-slab MIP images show the respective diameters of the aorta, and where we usually measure them. The green line indicates the aortic anulus, the blue line indicates the diameter of the root at the level of the sinuses of valsalve, and the yellow line measures the sino-tubular-junction. here is the mid portion of the ascending aorta 术前 VR (slab) VR (透明血液) 27 岁,男性， Marfans患者 手术步骤 冠脉开口 瓣膜腱索 冠脉再植入 术后 27 岁 男性 二尖瓣主动脉根动脉瘤 瓣膜脱垂伴严重动脉回流及左心室扩张 二瓣主动脉瓣 严重的L+R瓣小叶脱垂 Raphe L+R leaflet 二瓣主动脉瓣 严重的L+R瓣小叶脱垂 二瓣主动脉瓣 由于缝合处悬挂的“腱索”的破裂 R/L瓣膜的严重脱垂 L+R sinus raphe/chord 二瓣主动脉瓣 瓣膜保留术后 主动脉根的3D和4D成像 总结 成像技术: 胸部门控CT 胸主动脉的外科解剖学 临床关注 术前和术后的成像 - Marfan‘s 病变 - 二瓣主动脉瓣病变/动脉瘤 Thank you.. DC Miller RS Mitchell M Fischbein 2nd Symposium on Multislice CT of the Chinese Society of Radiology Stanford University, School of Medicine August 13-15, 2009 Dailan, China CT has a long successful