64排128层螺旋CT与1.5T MRI在主动脉夹层中的临床应用价值

发布时间：2018-08-08 17:19

【摘要】：目的:探讨64排128层螺旋CT与1.5T MRI在主动脉夹层中的临床应用价值。方法:选择临床诊断为主动脉夹层的60例患者进行CT与MRI检查,其中30例CT检查、30例MRI检查。60例均经心血管造影(DSA)检查。以DSA诊断为标准,比较CT与MRI在主动脉夹层中的应用价值。结果:CT和MRI在主动脉夹层诊断、分型、真假腔辨别、内膜片确定上达100%诊断率。CT/DSA显示破口15/19处、再破口6/11处、血管分支受累44/45支、假腔附壁血栓22/0处、溃疡24/25处、主动脉壁钙化12/0处。MRI/DSA显示破口6/15处、再破口5/10处、血管分支受累24/39支、假腔附壁血栓20/0处、溃疡10/21处、主动脉壁钙化0/0处。另外CT血管成像显示主动脉壁内血肿2例,DSA未显示;MRI/DSA组未显示。CT禁忌证4例(碘过敏2例、肾功能低1例、不愿接受X射线辐射1例)选择MRI检查。MRI禁忌证5例(心脏起博器1例、动脉瘤夹1例、幽闭恐怖症1例、主动脉夹层支架植入术后复查2例)选择CT检查。结论:CT与MRI对主动脉夹层的诊断、分型均具有较高的敏感性、特异性和准确性,但在破口、再破口及分支血管受累显示方面有一定差异,在禁忌证方面亦有差别,可以优势互补,以提高在临床中的应用价值。
[Abstract]:Objective: to evaluate the clinical value of 64-slice 128-slice spiral CT and 1.5 T MRI in aortic dissection. Methods: Ct and MRI were performed in 60 patients with aortic dissection, including 30 cases of CT and 30 cases of MRI. 60 cases were examined by (DSA). The value of CT and MRI in the diagnosis of aortic dissection was compared with that of DSA. Results CT and MRI were used to diagnose, type, distinguish true and false cavities in aortic dissection. The diagnostic rate of intimal film was 100%. CT-r / DSA showed that there were 15 / 19 ruptures, 6 / 11 broken holes, 44 / 45 branches of vascular branches, 22 / 0 thrombus attached to the wall of false lumen, and 24 / 25 of ulcers. Aortic wall calcification. MRI / DSA showed 6 / 15 broken, 5 / 10 broken, 24 / 39 branches involved, 20 / 0 false lumen wall thrombosis, 10 / 21 ulcers, 0 / 0 aortic wall calcification. In addition, CT angiography showed aortic intramural hematoma in 2 cases without MRI / DSA. In MRI / DSA group, 4 cases (2 cases of iodine hypersensitivity, 1 case of low renal function) were not shown contraindications of CT. 5 cases (1 case with cardiac pacemaker, 1 case with aneurysm clamp, 1 case with claustrophobia, 2 cases with aortic dissection stent implantation) were selected for MRI examination. Conclusion the diagnosis of aortic dissection by CT and MRI has high sensitivity, specificity and accuracy. However, there are some differences in showing the involvement of broken, rebroken and branched blood vessels, and in contraindication. It can complement each other in order to improve the clinical application value.
【作者单位】：南方医科大学附属医院深圳市龙华区人民医院医学影像科;北京大学深圳医院放射科;
【基金】：深圳市卫生和计划生育委员会科研项目(No:201402146)
【分类号】：R543.1

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