CAJ | 학술논문

目的：研究64排CT血管成像在主动脉夹层DeBakeyⅠ-Ⅲ型中的诊断和临床治疗中的应用价值。方法以我院2013年2月-2015年2月经手术或DSA证实的40例主动脉夹层患者进行回顾性分析，结合MSCT平扫及增强检查，在后处理工作站行多平面重组(MPR)、曲面重组(CPR)、最大密度投影(MIP)、容积再现(VR)重建。结果40例患者中, I型10例(25.0%)，II型3例(7.5%)，III型27例(67.5%)。64层螺旋CT诊断AD的特异度和敏感度均为100%。MPR和CPR对破口、真假腔及内膜瓣显示率分别为95.9%、100%。结论64排MSCT检查对主动脉夹层DeBakey分型快速、准确，能够清晰显示主动脉全程及分支变异、内膜瓣、破口、真假腔、剥离范围、分支血管受累、心包填塞等情况有重要的诊断价值，并可对各种急性胸主动脉疾病如心肌梗死、冠心病、肺动脉栓塞及时排除，是主动脉夹层临床诊断的首选和可靠的检查方法。
목적：연구64배CT혈관성상재주동맥협층DeBakeyⅠ-Ⅲ형중적진단화림상치료중적응용개치。방법이아원2013년2월-2015년2월경수술혹DSA증실적40례주동맥협층환자진행회고성분석，결합MSCT평소급증강검사，재후처리공작참행다평면중조(MPR)、곡면중조(CPR)、최대밀도투영(MIP)、용적재현(VR)중건。결과40례환자중, I형10례(25.0%)，II형3례(7.5%)，III형27례(67.5%)。64층라선CT진단AD적특이도화민감도균위100%。MPR화CPR대파구、진가강급내막판현시솔분별위95.9%、100%。결론64배MSCT검사대주동맥협층DeBakey분형쾌속、준학，능구청석현시주동맥전정급분지변이、내막판、파구、진가강、박리범위、분지혈관수루、심포전새등정황유중요적진단개치，병가대각충급성흉주동맥질병여심기경사、관심병、폐동맥전새급시배제，시주동맥협층림상진단적수선화가고적검사방법。
Objective To study the diagnostic value of 64-slice CT in type DeBakey I - III aortic dissection.Methods 40 cases of patients with aortic dissection confirmed by pathology or DSA admitted into the hospital from February 2013 to February 2015 were selected as the research object and all received 64-slice CT scan. The image data was processed by 3D reconstruction and the CT imaging features were analyzed.Results There were 10 cases (25%) of type I, 3 cases (7.5%) of type II and 27 cases (67.5%) of type III. True lumen was mainly circular, accounting for 75.0% while false lumen mainly was crescent shaped, accounting for 75.0%. Intimal tears located in the proximal descending aorta accounted for 42.5%, in ascending aorta for 32.5% and 10% without show. CT scan: there was 4 cases of false lumen of high density and 7 cases of intimal calcification calcified plaque ingression; enhanced scanning: there were 17 cases of true and false lumen in arterial phase significantly enhanced and the enhancement degree of true lumen was of 19 cases greater than that of the false lumen; In venous phase, the density of false lumen was of34 cases greater than that of the true lumen. There were 2 cases of rue and false lumen with the same density; In addition, there were 4 cases of false lumen without enhancement or small pieces with enhancement.Conclusion 64-slice spiral CT is of important diagnostic value in aortic dissection DeBakey typing, identification of true and false cavity and crevasse display. It is worth further application in the clinical diagnosis of aortic dissection.