CAJ | 학술논문

目的：探讨自发性孤立性肠系膜上动脉夹层（SISMAD）的多层螺旋CT血管成像（MSCTA）影像表现。方法回顾分析2008年5月至2013年5月间13例SISMAD患者[男12例，女1例，年龄44~87岁，平均（70.4±14.1）岁]的临床和MSCTA资料，并作相应分型。结果根据Yun分型，Ⅰ型5例，Ⅱ型7例（ⅡA型2例，ⅡB型5例），Ⅲ型1例；其中1例Ⅲ型按Sakamoto分型不能分型，曾误诊为栓塞。5例ⅡB型病变特殊，与其余病变表现不同。MSCTA显示内膜片、真假腔及破口良好，破口距离肠系膜上动脉（SMA）起始部0.3~5.5cm，平均2.3cm，其中3例超过2.5cm。结论 SISMAD有典型MSCT血管造影表现，良好分型可以显示病变特点，有助于临床处置。
목적：탐토자발성고립성장계막상동맥협층（SISMAD）적다층라선CT혈관성상（MSCTA）영상표현。방법회고분석2008년5월지2013년5월간13례SISMAD환자[남12례，녀1례，년령44~87세，평균（70.4±14.1）세]적림상화MSCTA자료，병작상응분형。결과근거Yun분형，Ⅰ형5례，Ⅱ형7례（ⅡA형2례，ⅡB형5례），Ⅲ형1례；기중1례Ⅲ형안Sakamoto분형불능분형，증오진위전새。5례ⅡB형병변특수，여기여병변표현불동。MSCTA현시내막편、진가강급파구량호，파구거리장계막상동맥（SMA）기시부0.3~5.5cm，평균2.3cm，기중3례초과2.5cm。결론 SISMAD유전형MSCT혈관조영표현，량호분형가이현시병변특점，유조우림상처치。
Objective To evaluate the MSCT angiography (MSCTA) findings of spontaneous isolated superior mesenteric artery dissection (SISMAD). Methods Thirteen patients were diagnosed as SISMAD from May 2008 to May 2013 in our depart-ment, including 12 males and 1 female with a mean age of 70.4±14.1y (44~87). The clinical presentations and MSCTA findings were retrospectively analyzed, and the classification was made. Results According to Yun's classification, 5 patients were clas-sified as type I, 7 were typeⅡ (2ⅡA and 5ⅡB), and 1 was type Ⅲ. The patient with typeⅢ was not able to be classified by Sakamoto classification and misdiagnosed as thromboembolism. Five patients with typeⅡB had the special CT findings different from the others. The intimal flap, true and false lumen, and entry sites were clearly revealed with MSCTA in al patients. The entry sites were located in the proximal superior mesenteric artery (mean 2.3 cm) in most patients (10/13). Conclusion The SISMAD have typical MSCTA findings. The accurate classification would reveal the characteristics and be helpful to the management.