CAJ | 학술논문

目的：探讨外伤性主动脉夹层的早期CT表现。方法：回顾性分析在我院漏诊及确诊的外伤性主动脉夹层的CT表现。2例中1例行3次CT 平扫，1例行CT 平扫和增强扫描。结果：2例均为DeBakey Ⅲ型主动脉夹层，1例3次CT平扫示降主动脉管腔进行性增宽，伴双侧胸腔积液；此例因漏诊，患者于2周后死亡。另1例 CT 平扫示降主动脉增粗，CT增强扫描明确诊断，主要表现为降主动脉扩张，可见真腔、假腔及内膜线；此例患者行支架植入术后，患者预后良好。结论：对于胸部外伤患者，CT平扫时应注意观察主动脉的直径，如果降主动脉增粗、尤其是进行性增粗时，应考虑主动脉夹层的可能。
목적：탐토외상성주동맥협층적조기CT표현。방법：회고성분석재아원루진급학진적외상성주동맥협층적CT표현。2례중1례행3차CT 평소，1례행CT 평소화증강소묘。결과：2례균위DeBakey Ⅲ형주동맥협층，1례3차CT평소시강주동맥관강진행성증관，반쌍측흉강적액；차례인루진，환자우2주후사망。령1례 CT 평소시강주동맥증조，CT증강소묘명학진단，주요표현위강주동맥확장，가견진강、가강급내막선；차례환자행지가식입술후，환자예후량호。결론：대우흉부외상환자，CT평소시응주의관찰주동맥적직경，여과강주동맥증조、우기시진행성증조시，응고필주동맥협층적가능。
Objective:To study the CT features of the traumatic aortic dissection (AD)and improve the early diagnos-tic accruary of AD.Methods:The CT features of two patients with traumatic aortic dissection confirmed by autopsy (in one case)and stent implantation after DSA (in another case)were analyzed retrospectively.Of the two cases,one case under-went three times of plain CT,one was performed with plain and contrast-enhanced CT scan.Results:The two cases were both of DeBakey type Ⅲof aortic dissection.In one case,progressive expansion of the descending aorta with bilateral pleural effusions was showed on plain CT and follow-up CT images.In another case,expansion of the descending aorta was showed on plain CT,and then multi-slice CT angiography showed the signs of AD,including true and false lumen and intimal flap, and confirmed the diagnosis of AD.Conclusion:For patients with chest trauma,it is important to analyze the dimension change of the aorta on plain CT scan,and ecstasis especially progressive ecstasis of descending aorta can be an important sign for the diagnosis of AD.