CAJ | 학술논문

目的探讨主动脉瓣和(或)升主动脉置换手术后,主动脉根部-右心房耳分流术患者的CT影像特点.方法回顾性分析行主动脉根窦部手术且同时行右心房耳人工造口分流术的87例患者,术后采用电子束CT(EBCT)或16、64层CT扫描机行非心电门控连续容积增强扫描,扫描范围自主动脉弓上水平至左、右髂动脉分叉处.86例患者于术后2～20d内行首次CT检查,1例术后15年行CT检查.结果 87例患者CT均明确诊断主动脉血管吻合口漏,异常血流经右心房耳口引流入右心房.少量分流25例,中量分流47例,大量分流15例(其中1例患者术后15年升主动脉周围大量对比剂外溢,右心房、室明显增大).术后复查CT超过2次的患者37例,其中10例随访期内见少至中量分流漏口消失,8例少量分流较前减少,14例少至中量分流较前无明显变化,5例中量分流者3个月后复查分流较前增加.结论右心房耳分流术患者CT为首选检查手段,可明确分流情况且定量分类,根据其影像特点可为临床提供治疗依据,亦是术后随访的主要方法.
목적 탐토주동맥판화(혹)승주동맥치환수술후,주동맥근부-우심방이분류술환자적CT영상특점.방법 회고성분석행주동맥근두부수술차동시행우심방이인공조구분류술적87례환자,술후채용전자속CT(EBCT)혹16、64층CT소묘궤행비심전문공련속용적증강소묘,소묘범위자주동맥궁상수평지좌、우가동맥분차처.86례환자우술후2～20d내행수차CT검사,1례술후15년행CT검사.결과 87례환자CT균명학진단주동맥혈관문합구루,이상혈류경우심방이구인류입우심방.소량분류25례,중량분류47례,대량분류15례(기중1례환자술후15년승주동맥주위대량대비제외일,우심방、실명현증대).술후복사CT초과2차적환자37례,기중10례수방기내견소지중량분류루구소실,8례소량분류교전감소,14례소지중량분류교전무명현변화,5례중량분류자3개월후복사분류교전증가.결론 우심방이분류술환자CT위수선검사수단,가명학분류정황차정량분류,근거기영상특점가위림상제공치료의거,역시술후수방적주요방법.
Objective To evaluate the CT features of aorto-right atrial fistula after aortic valve replacement(AVR) or ascending aortic replacement.Methods Eighty-seven patients with aortic-right atrial fistula underwent CT after operation.The CT features were retrospectively analyzed.Fistula was measured according to maximum width of the shunt.Results Aorto-right atrial fistula was detected in 87 patients after aortic valve replacement or ascending aortic replacement by CT scan. Among them,25 patients were diagnosed as mild aorto-right atrial fistula,47 patients as moderate,and 15 patients as severe.Thirty-seven patients underwent follow-up CT.Among them,10 patients with mild to moderate aorto-right atrial fistula were considered to have complete regression,8 patients with mild aorto-right atrial fistula considered to have incomplete regression,14 patients with mild to moderate aorto-right atrial fistula considered to have stable condition,and 5 patients with moderate aorto-right atrial fistula considered to have progression at the 3-month follow-up.Conclusion CT is a useful tool for defining aorto-right atrial fistula after AVR or ascending aortic replacement and for evaluating it in follow-up.