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目的:分析并总结不典型主动脉夹层(AAD)的MSCT影像表现特征,评价MSCT对该病的临床诊断价值。方法:回顾性分析13例AAD病例的MSCT平扫及CTA征象,诊断参照Stanford分型。结果:Stanford A型3例,B型10例。13例病变主动脉壁呈新月形或环形增厚,平扫呈高密度,增强无强化,5例内膜钙化内移。其中伴内膜渗漏2例、穿透性溃疡3例,主动脉外径增宽3例、管腔内径变窄2例、动脉粥样硬化9例,并发心包积液1例、胸腔积液4例。结论:AAD的CT影像学表现有其特征性,主动脉壁新月形或环形增厚是其特征性影像学表现,可伴有内膜钙化内移、内膜渗漏、穿透性溃疡、主动脉形态改变、动脉粥样硬化等,常并发心包及胸腔积液。MSCT增强前后扫描诊断AAD优势明显,平扫结合临床可以强烈提示AAD,CTA具有确诊价值。
Objective: To analyze and summarize the features of MSCT images of atypical aortic dissection (AAD) and evaluate the clinical value of MSCT in the diagnosis of this disease. Methods: MSCT and CTA findings of 13 AAD cases were retrospectively analyzed. The diagnosis was based on Stanford classification. Results: Stanford type A in 3 cases and type B in 10 cases. 13 cases of aortic wall crescent or annular thickening, high density scan, enhanced without enhancement, 5 cases of endometrial calcification within. Among them, there were 2 cases of endometrial leakage, 3 cases of penetrating ulcer, 3 cases of widening of aorta diameter, 2 cases of narrowing of lumen diameter, 9 cases of atherosclerosis, 1 case of pericardial effusion and 1 case of pleural effusion 4 cases. CONCLUSIONS: The features of CT imaging of AAD are characterized by crescent or ring thickening of the aortic wall, which is characterized by endometrial calcification, endometrial leakage, penetrating ulceration, Aortic morphology changes, atherosclerosis, etc., often complicated by pericardial and pleural effusion. MSCT enhanced scan AAD obvious advantages, combined with plain scan can strongly suggest that AAD, CTA has a diagnostic value.