【摘要】 目的 探讨多层螺旋CT血管成像(MSCTA)在孤立性肠系膜上动脉夹层(SIDSMA)诊断中的应用价值。方法 对7例SIDSMA患者行MSCT扫描,采用最大密度投影(MIP)、曲面重组(CPR)、多平面重组(MPR)、容积再现(VR)等多种技术进行图像后处理。结果 按照Sakamoto分型标准:Ⅰ型3例,Ⅱ型2例,Ⅲ型1例,Ⅳ型1例。7例肠系膜上动脉(SMA)病变段均有增粗,最大径10.2～13.1 mm。近端内膜破裂口与SMA开口距离6.7～49.7 mm。6例假腔主要位于真腔腹侧,1例假腔位于真腔右侧。7例夹层真腔受压狭窄,假腔内血栓形成4例。4例夹层累及SMA分支。SMA周围脂肪间隙模糊2例。结论 MSCTA能为SIDSMA的临床诊断和治疗提供有价值的信息,可作为SIDSMA诊断的首选影像学方法。更多还原

【Abstract】 Objective To evaluate the value of multi-slice spiral CT angiography(MSCTA) in the diagnosis of spontaneous isolated dissection of the superior mesenteric artery(SIDSMA).Methods 7 patients with SIDSMA were performed MSCT scanning.Various image post-processing techniques such as maximum intensity projection(MIP),curved planar reformation(CPR),multiplanar reconstruction(MPR) and volume rendering(VR) were applied.Results According to Sakamoto ’ s classification,three cases were type,two cases were type Ⅱ,one case was type Ⅲ and one case was type Ⅳ.The 7 patients’ SMA lesions segments diameter were enlarged.Maximum diameter was 10.2-13.1 mm.The distance between proximal intimal rupture and SMA opening was6.7-49.7 mm.False cavities mainly located in the ventral of the true lumen in 6 patients.1 false cavity located on the right side of the true lumen.The dissection true lumens were narrowed because of compression in the 7 patients.The thrombosis were presented in false lumens in 4 patients.4 patients showed dissection involving SMA branches.The fat clearance fuzzy were presented in the 2patients.Conclusion MSCTA plays an important role in clinical diagnosis and treatment of SIDSMA.更多还原