复杂腹主动脉瘤颈的CT血管成像在腹主动脉瘤腔内修复术中的价值

发布时间：2018-06-03 03:12

  本文选题：腹主动脉瘤 + 瘤颈　； 参考：《心肺血管病杂志》2016年09期

【摘要】：目的:探讨CT血管成像(CTA)在复杂型腹主动脉瘤腔内修复术前评估中的临床应用价值。方法:回顾性分析2014年1月至2015年12月间,于我中心经腔内修复的58例复杂型腹主动脉瘤患者,男性42例,年龄57~80岁,平均年龄(71.3±6.6)岁,术前CTA影像资料,对瘤颈的直径变化、角度、长度进行分析测量,并与术中造影结果(DSA)比较。结果:(1)CT证实单因素复杂瘤颈7例,占12.1%,多因素复杂瘤颈51例,占87.9%,其中短瘤颈合并锥形瘤颈14例,占24.1%,锥形瘤颈合并瘤颈夹角60°的37例,占63.8%。(2)CTA与DSA测量值比较:瘤体最大直径平均[(53.2±7.3)vs.(45±5.6)mm,t=4.022,P0.001;肾下腹主动脉直径平均[(20.1±3.3)vs.(20.7±3.8)mm,t=0.793,P0.05],瘤体入口处腹主动脉直径平均[(19.2±2.8)vs(18.7±3.1)mm,t=0.728,P0.05),差值平均[(1.9±0.8)vs.(0.9±0.5)mm,t=1.047,P0.05];瘤颈与瘤体成角平均[(49.3o±17.2o)vs.(36.4o±16.3o),t=5.416,P0.001;瘤颈长度平均[(27.7±5.1)vs.(25.7±6.5)mm,t=1.873,P0.05)。(3)手术成功率100%,术中造影发现即刻I型内漏18例,占31.0%,17例经球囊扩张内漏消失,1例通过近端补CUFF内漏消失;随访3个月支架稳定,未见移位,无I型内漏,各分支血管通畅。结论:腹主动脉瘤腔内修复术前应用CTA评估复杂瘤颈形态,对手术成功有决定性意义。对于瘤体最大径和瘤颈夹角应参考CTA的测量结果,瘤颈长度及直径变化与术中DSA无显著性差异。
[Abstract]:Objective: to evaluate the clinical value of CT angiography (CTAA) in the preoperative evaluation of intraluminal repair of complex abdominal aortic aneurysms. Methods: from January 2014 to December 2015, 58 patients with complex abdominal aortic aneurysm (42 males, 5780 years old, mean age 71.3 卤6.6) underwent endovascular repair in our center. The preoperative CTA imaging data and the diameter of the neck of the aneurysm were analyzed retrospectively. Angle and length were measured and compared with the results of intraoperative angiography. Results 7 cases (12.1%) of mono-factor complex tumor neck were confirmed by CT scan, 51 cases (87.9%) of multivariate complex tumor neck, including 14 cases of short neck with conical neck, accounting for 24.1 cases, and 37 cases of conical neck complicated with 60 掳angle of tumor neck. 鍗，

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