【摘要】 目的探讨256层螺旋CT技术在动脉瘤腔内支架修复术(EVAR)后严重并发症的诊断及随访中的应用价值。方法分析40例EVAR患者术前及术后CTA的影像资料,术前CTA测量瘤颈、瘤体的大小,并评估不良近端锚定区,术后CTA重点观察有无内漏、支架内血栓形成及瘤腔大小的变化等。比较Ⅰ型内漏与无Ⅰ型内漏患者在不良近端锚定区的差异,并比较有无内漏患者在瘤腔大小变化的差异。结果术后CTA共发现内漏8例,其中Ⅰ型内漏4例,Ⅱ型和Ⅲ型内漏各2例,Ⅰ型内漏均位于移植物近端,Ⅰ型内漏患者中,75.0%(3/4)的患者存在不良近端锚定区,明显高于无Ⅰ型内漏患者(11.1%,4/36),差异具有统计学意义(P=0.013)。2例(8.3%)出现移植物内血栓形成。8例出现瘤体增大,其中6例(75.0%)为内漏患者,2例(6.3%)为无内漏患者,差异具有统计学意义(P=0.000)。结论 256层MSCTA可以对EVAR术后严重并发症作出准确诊断,并为进一步治疗提供影像学依据,是首选的影像学检查方法之一。更多还原

【Abstract】 Objective To evaluate the value of 256 MSCTA for the diagnosis of severe complications and follow-up of endovascular aneurysms repair( EVAR). Methods Between Mar. 2010 and Jul. 2014,Pre- and post- EVAR CTA of forty aortic aneurysms( AA) was used to calculate the size of AA neck and body,and to assess the hostile neck anatomy( HNA) before EVAR,and to evaluate the complications and changes of AA size after EVAR,respectively. Results Eight endoleaks were found including 4 type Ⅰ endoleaks,2 type Ⅱ endoleaks and 2 type Ⅲ endoleaks. All the type Ⅰendoleaks were located around proximal graft attachment zone. Type Ⅰ endoleaks were found more frequently in the patients with HNA than patients without HNA( P = 0. 013). Thrombosis in the graft was found in 2 patients. In the postEVAR CTA,AA enlargement was found in 6 of 8 patients( 75. 0%) with endoleaks,and only 2 of 32 patients without endoleak,and the difference was significant( P = 0. 000). Conclusion 256 MSCTA is favorable for demonstrating the severe complications,and providing the evidence for the-intervention,has become one of preferred imaging methods for the follow-up after EVAR.更多还原