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目的探讨CT血管造影(CT angiography,CTA)在外伤性盆腔动脉假性动脉瘤及夹层动脉瘤中的临床应用价值。方法选取2012年8月—2016年1月在遂宁市中心医院经CTA诊断为盆腔动脉假性动脉瘤(7例)和夹层动脉瘤(1例)的患者为研究对象,其中6例假性动脉瘤患者经数字减影血管造影技术证实,并行假性动脉瘤栓塞术。CTA图像后处理技术主要包括曲面重建、多平面重建及容积再现。结果经CTA诊断为盆腔动脉假性动脉瘤的7例患者中,臀下动脉假性动脉瘤3例,臀上动脉假性动脉瘤2例,髂外动脉假性动脉瘤2例,均为单发。7枚瘤体呈囊袋状,瘤体短径9~64 mm,长径11~78 mm;7枚瘤体中,6枚动脉破口能清晰显示,其中1例患者合并动静脉瘘。此外,1例右侧髂外动脉局限性夹层动脉瘤患者合并左侧髂外动脉血栓形成,致相应层面血管腔闭塞。结论 CTA作为一种非创伤性检查,可准确诊断外伤性盆腔动脉假性动脉瘤及夹层动脉瘤,能清晰显示假性动脉瘤与载瘤动脉关系,以及是否合并动静脉瘘;能准确诊断夹层动脉瘤及其真假腔,为制定治疗计划提供重要影像信息。
Objective To investigate the clinical value of CT angiography (CTA) in traumatic pelvic pseudoaneurysm and dissecting aneurysm. Methods From August 2012 to January 2016, patients with pseudoaneurysm (pelvic artery pseudoaneurysm (7 cases) and dissecting aneurysm (1 case) diagnosed by CTA in Suining Central Hospital were studied. Six cases of pseudoaneurysm Patients were confirmed by digital subtraction angiography and concurrent pseudoaneurysm embolization. CTA image post-processing techniques include surface reconstruction, multi-planar reconstruction and volume rendering. Results Of the 7 patients diagnosed as pseudoaneurysm of pelvic artery by CTA, there were 3 cases of inferior pseudoaneurysm of inferior gluteal artery, 2 cases of pseudoaneurysm of superior gluteal artery and 2 cases of false aneurysm of external iliac artery, all of which were single hair. The 7 tumors were pouchy in size, with the short diameter of 9 ~ 64 mm and the long diameter of 11 ~ 78 mm. Of the 7 tumors, 6 of the 7 aneurysms were clearly shown. One of them had arteriovenous fistula. In addition, a right external iliac artery dissecting aneurysm in patients with left external iliac artery thrombosis, resulting in the corresponding level of vascular occlusion. Conclusion CTA as a non-invasive examination can accurately diagnose traumatic pseudoaneurysm and dissecting aneurysm of pelvic artery, and can clearly show the relationship between pseudoaneurysm and parent artery, and whether it is associated with arteriovenous fistula. It can accurately diagnose the dissection Aneurysms and their true and false lumen provide important image information for the development of treatment plans.