主动脉憩室的多种影像学诊断和临床应用价值的比较

发布时间：2018-01-20 02:48

本文关键词： 右位主动脉弓主动脉憩室体层摄影术 X线胸片　出处：《中国循环杂志》2015年07期 　论文类型：期刊论文

【摘要】：目的:探讨影像学检查,特别是多层螺旋计算机断层摄影术(MSCT)在先天性主动脉憩室中的诊断价值。方法:对MSCT、超声心动图及X线平片诊断的12例主动脉憩室患者的影像学数据进行回顾性分析。结果:9例患者为右位主动脉弓、1例左位主动脉弓,均有迷走锁骨下动脉并起始部瘤样扩张,呈憩室样改变(Kommerell憩室);1例为不完整主动脉双弓,左弓闭锁并食管后主动脉憩室;1例为导管憩室。超声心动图仅对4例患者作出降主动脉血流速度加快或右位主动脉弓的诊断。MSCT均能准确显示憩室的位置、形态以及有无其它合并症;其中8例患者胸部X线平片提示"双侧主动脉结"这一较为特异性的征象。超声心动图、X线平片和MSCT对主动脉憩室的诊断正确率分别是0.0%;72.7%和100.0%。结论:MSCT是一种较为理想的无创性诊断主动脉憩室的检查方法;同时也要重视X线平片的提示性诊断作用;联合超声检查对了解患者心脏瓣膜的结构、血流动力学现状有益。
[Abstract]:Objective: to evaluate the diagnostic value of imaging examination, especially MSCT in congenital aortic diverticulum. Methods: MSCT. The imaging data of 12 patients with aortic diverticulum diagnosed by echocardiography and X-ray plain film were retrospectively analyzed. The subclavian artery was dilated with tumor-like dilatation of the initial part, and the Kommerell's diverticulum was changed in the form of diverticulum. One patient had incomplete aortic double arch, left arch atresia and posterior aortic diverticulum. One case was a diverticulum. Echocardiography showed the location, morphology and other complications of diverticulum in only 4 patients with accelerated descending aortic flow velocity or right aortic arch. The chest X-ray plain film of 8 patients showed a more specific sign of "bilateral aortic node". The diagnostic accuracy of echocardiographic X-ray plain film and MSCT for aortic diverticulum was 0.010%, respectively. Conclusion: MSCT is an ideal noninvasive method for the diagnosis of aortic diverticulum. At the same time, we should also pay attention to the role of X-ray plain film in prompt diagnosis. Combined ultrasonography is helpful to understand the structure and hemodynamics of heart valve in patients.
【作者单位】：武汉亚洲心脏病医院影像科;
【分类号】：R543.1;R816.2;R540.45
【正文快照】： 主动脉憩室是先天性主动脉畸形的一种较为常见的类型,表现为不同部位主动脉囊袋状扩张,其中最常见的当属Kommerell憩室,偶可引起呼吸、吞咽困难,严重者或引起主动脉夹层。多层螺旋计算机摄影术(MSCT)应用于临床以来,以其成像快速,图像分辨率高等特点,在心外大血管影像诊断中越

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