【摘要】 目的:探讨多层螺旋CT血管成像(MSCTA)在自发性腹部内脏动脉夹层诊断中的临床应用价值。方法:回顾性分析10例次(8例)自发性腹部内脏动脉夹层患者CT原始及后处理图像,观察夹层真假双腔、剥离内膜片、内膜破裂口、累及长度、假腔内血栓、夹层动脉是否瘤样扩张或狭窄、内脏有无缺血及梗死。结果:MSCTA图像清晰,均清楚显示自发性腹部内脏动脉夹层,其中肠系膜上动脉夹层4例,腹腔干夹层累及脾动脉2例,右肾动脉夹层、左肾动脉夹层、脾动脉夹层及腹腔干夹层各1例。横轴面CT、MPR及CPR图像均可显示夹层真假双腔及剥离内膜片,显示内膜破裂口4例、假腔内血栓6例、夹层动脉瘤样扩张7例;MIP、VR图像显示夹层动脉瘤样扩张2例,真腔狭窄5例,剥离内膜片4例,内膜破裂口3例;SSD图像显示夹层动脉瘤样扩张2例,真腔狭窄5例。结论:MSCTA能直观地显示自发性腹部内脏动脉夹层,可作为诊断本病的无创、快速、准确的检查方法。更多还原

【Abstract】 Objective:To evaluate the clinical application of multislice spiral CT angiography(MSCTA)in diagnosing spontaneous abdominal visceral artery dissection.Methods:10 cases of spontaneous abdominal visceral artery dissection with primary axial CT and post-processing images were retrospectively analyzed to observe true and false double lumen,the detached intimal flap,ruptured intimal orifice and its length,thrombus in the false lumen,aneurysmal expansion or stenosis of dissection,visceral ischemia or infarction etc.Results:High quality MSCTA showed spontaneous abdominal visceral artery dissection clearly,including superior mesenteric artery dissection(n=4),celiac trunk dissection involving splenic artery(n=2),right renal artery dissection(n=1),left renal artery dissection(n=1),splenic artery dissection(n=1)and celiac trunk dissection(n=1).Axial CT,MPR and CPR could display true and false lumen and detached intimal flap,including ruptured intimal orifice(n=4),thrombus in the false lumen(n=6)and aneurysmal expansion(n=7)of dissection.MIP and VR showed aneurysmal expansion(n=2),stenosis of true lumen(n=5),detached intimal flap(n=4)and ruptured intimal orifice(n=3).SSD displayed aneurysmal expansion(n=2)and stenosis of true lumen(n=5).Conclusion:MSCTA can intuitively display spontaneous abdominal visceral artery dissection,providing as a non-invasive,fast and accurate diagnostic management.更多还原