CAJ | 학술논문

目的总结孤立性肠系膜上动脉夹层(SMAD)的多层螺旋CT(MSCT)及数字减影血管造影(DSA)的影像学特征及其在SMAD诊断中的临床意义. 方法回顾性分析16例孤立性SMAD患者临床及影像资料,总结孤立性SMAD的影像学特征. 结果 16例患者均行MSCT检查,其中6例行DSA造影.SMAD病变均位于SMA主干.4例为Ⅱa型,3例为Ⅱb型,9例为壁间血肿型.真腔狭窄＞80％、80％～50％、＜50％分别为2、5、9例.7例患者可判断破裂口位置,距肠系膜上动脉起始部1～5 cm,平均(1.7±0.8)cm.MSCT影像学特征:平扫真假腔均表现为等密度,无特异性表现;动脉期的双腔结构:假腔呈“新月形”或“环形”低密度影包绕真腔,伴夹层动脉瘤形成的患者真假腔呈“8字形”改变,假腔呈囊样扩张.DSA影像学特征:均可见夹层动脉瘤及内膜片、破裂口. 结论孤立性SMAD的MSCT及DSA具有特征性表现,MSCT可以作为SMAD的筛查及随访复查的重要手段;DSA可以进一步对病变及周围侧支循环的代偿情况进行评价,同时可以行腔内支架治疗.
목적 총결고립성장계막상동맥협층(SMAD)적다층라선CT(MSCT)급수자감영혈관조영(DSA)적영상학특정급기재SMAD진단중적림상의의. 방법 회고성분석16례고립성SMAD환자림상급영상자료,총결고립성SMAD적영상학특정. 결과 16례환자균행MSCT검사,기중6례행DSA조영.SMAD병변균위우SMA주간.4례위Ⅱa형,3례위Ⅱb형,9례위벽간혈종형.진강협착＞80％、80％～50％、＜50％분별위2、5、9례.7례환자가판단파렬구위치,거장계막상동맥기시부1～5 cm,평균(1.7±0.8)cm.MSCT영상학특정:평소진가강균표현위등밀도,무특이성표현;동맥기적쌍강결구:가강정“신월형”혹“배형”저밀도영포요진강,반협층동맥류형성적환자진가강정“8자형”개변,가강정낭양확장.DSA영상학특정:균가견협층동맥류급내막편、파렬구. 결론 고립성SMAD적MSCT급DSA구유특정성표현,MSCT가이작위SMAD적사사급수방복사적중요수단;DSA가이진일보대병변급주위측지순배적대상정황진행평개,동시가이행강내지가치료.
Objective To investigate the imaging features of isolated superior mesenteric artery dissection (SMAD).Methods A retrospective analysis of 16 cases of clinical and imaging data in patients with SMAD to summarize the imaging features of SMAD.Results All patients underwent multi-slice CT,and 6 of them underwent digital subtraction angiography (DSA).The SMAD were all located in the trunk of SMA.Type Ⅱ a,Ⅱ b,and intramural hematoma were in 4,3 and 9 cases,respectively.The true lumen stenosis ＞ 80％,80％～ 50％,＜ 50％ were in 2,5,9 cases,respectively.The rupture location could be judged in 7 cases with (1.7±0.8) (1～5) cm from the ostium of SMAD.MSCT imaging characteristics of SMAD:plain false lumen showed an equal density without specific performance; the false lumen showed "crescent" or "donut" low density surrounding the true lumen; the true and false lumen showed "8-shaped" change in patients with aneurysm,with the false lumen being cystic dilatation.In DSA imaging,the aneurysm,intimal flap and rupture location can be seen.Conclusions MSCT and DSA show special features for SMAD.MSCT can diagnose isolated SMAD correctly.DSA can be used to evaluate the disease and collateral circulation and used for interventional treatment at the same time.