CAJ | 학술논문

目的探讨多层螺旋CT血管成像（CTA）在主动脉壁内血肿（AIh）诊断中的临床应用价值及诊断优势。方法对26例经256层螺旋CTA诊断为AIh的患者，运用多平面重建（MPR）、最大密度投影（MIP）、容积重建（VR）等，结合轴位图像，分析AIh的部位、形态、有无溃疡及胸腔积液等。结果单纯AIh 7例，表现为沿主动脉壁的环状或新月形低密度，CTA显示没有强化，主动脉内壁光滑；溃疡性AIh 19例。18例溃疡周围有较明显粥样斑块和钙化斑块，1例无粥样斑块和钙化斑块；3例有少量胸腔积液，15例溃疡性AIh合并中等以上胸腔积液。结论多层螺旋CTA可无创清晰显示AIh，对临床的诊断、治疗和随访具有重要的指导意义。
목적탐토다층라선CT혈관성상（CTA）재주동맥벽내혈종（AIh）진단중적림상응용개치급진단우세。방법대26례경256층라선CTA진단위AIh적환자，운용다평면중건（MPR）、최대밀도투영（MIP）、용적중건（VR）등，결합축위도상，분석AIh적부위、형태、유무궤양급흉강적액등。결과단순AIh 7례，표현위연주동맥벽적배상혹신월형저밀도，CTA현시몰유강화，주동맥내벽광활；궤양성AIh 19례。18례궤양주위유교명현죽양반괴화개화반괴，1례무죽양반괴화개화반괴；3례유소량흉강적액，15례궤양성AIh합병중등이상흉강적액。결론다층라선CTA가무창청석현시AIh，대림상적진단、치료화수방구유중요적지도의의。
Objective To evaluate the effects of MSCT (Multi-slice Computerized Tomography) in diagnosis of AIH (Aortic Intramural Hematoma). Methods MpR ( Multi-planar Reformation), MIp ( Maximum Intensity projection) and VR ( Volume Rendering) in combination with axial imaging were performed in 26 patients who underwent 256-slice spiral CT scans and were determined as AIH patients so as to analyze the location, morphological features and existence of ulcers and pleural effusion in all the cases. Results Among 26 cases, simplex AIH was found in 7 patients whose pathological changes manifested low-density ring-shape or crescent along the aortic wall with the features of smoothing aortic wall and no enhancement under CTA scanning;19 patients were conifrmed as ulcerated AIH (18 cases showed obvious atheromatous and calciifc plaque around the ulcers, among which a small amount of pleural effusion was found in 3 cases and there were 15 cases of ulcerated AIH who had moderate or large amount of pleural effusion;while, 1 case showed no atheromatous and calciifc plaque around the ulcers). Conclusion MSCT served as a non-invasive technique that could give a clear demonstration of AIH and had great signiifcance in clinical diagnosis, treatment and follow-up examinations of AIH patients.