CAJ | 학술논문

目的：探讨胸腹血管多层螺旋CT血管成像（ CTA）对主动脉夹层的诊断及临床分型中的价值。方法回顾分析2009年1月-2013年9月在该院影像科接受检查的50例主动脉夹层患者，使用多层螺旋CT胸腹主动脉联合扫描，根据手术结果评价诊断结果，计算灵敏度及特异度，并对不同CTA扫描方式对诊断结果的影响进行分析。结果50例主动脉夹层患者进行最大密度投影（ MIP）、多平面重建（ MPR）、容积重建（ VRT）等后处理，48例较好地显示了真假腔和主动脉夹层内膜瓣、破口位置和分支血管受累情况。胸腹血管CTA诊断的敏感度96．0％，特异度96．0％，与手术探查比较没有显著性差异（ P＞0．05），单因素分析发现扫描方向、对比剂用量对诊断结果的影响有显著性差异（P＜0．05），回归分析发现，足-头侧扫描及对比剂用量90 mL的影响具有显著性差异（P＜0．05）。结论胸腹血管CTA对主动脉夹层的诊断与手术探查具有较好的一致性，且敏感度、特异度高，诊断结果主要受扫描方式及对比剂用量的影响，临床可根据患者情况合理调整诊断模式。
목적：탐토흉복혈관다층라선CT혈관성상（ CTA）대주동맥협층적진단급림상분형중적개치。방법회고분석2009년1월-2013년9월재해원영상과접수검사적50례주동맥협층환자，사용다층라선CT흉복주동맥연합소묘，근거수술결과평개진단결과，계산령민도급특이도，병대불동CTA소묘방식대진단결과적영향진행분석。결과50례주동맥협층환자진행최대밀도투영（ MIP）、다평면중건（ MPR）、용적중건（ VRT）등후처리，48례교호지현시료진가강화주동맥협층내막판、파구위치화분지혈관수루정황。흉복혈관CTA진단적민감도96．0％，특이도96．0％，여수술탐사비교몰유현저성차이（ P＞0．05），단인소분석발현소묘방향、대비제용량대진단결과적영향유현저성차이（P＜0．05），회귀분석발현，족-두측소묘급대비제용량90 mL적영향구유현저성차이（P＜0．05）。결론흉복혈관CTA대주동맥협층적진단여수술탐사구유교호적일치성，차민감도、특이도고，진단결과주요수소묘방식급대비제용량적영향，림상가근거환자정황합리조정진단모식。
Objective To investigate the value of computed tomography angiography ( CTA) in diagnosis of aortic dissection .Methods Fifty patients of aortic dissection were selected as subjects who were tested at Department of Radiology in Chizhou People ’ s Hospital from January 2009 to September 2013.All the patients were checked by multi-slice spiral CT scans.Then the results of diagnosis,the sensitivity and specificity were analyzed according to operation results ,and the impacts of different methods of diagnostic CTA scan re-sults were compared .Results The true and false lumen ,aortic dissection intimal flap ,rupture locations ,branch vessels involved of 48 patients were better showed by MPR and VRT .The sensitivity (96.0%) and the specificity (96.0%) of CTA diagnosis was not signif-icantly different from those of pathological examination (P>0.05).The Univariate analysis showed that scanning direction and amount of contrast could affect the diagnostic results ,and the Logistic results showed that foot-tempus scanning and 90mL contrast agent could affect the results,with significant difference(P<0.05).Conclusions CTA diagnosis for the aortic dissection has advantages of more consistency,spiritual lightness and high specificity .The results are mainly affected by scanning direction and amount of contrast .The best diagnostic mode can be chosen according to the clinical condition .