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目的:对比分析急诊主动脉夹层应用多层螺旋CT和超声心动图诊断的应用价值。方法:选取2014年12月至2016年12月我院收治的经CT血管显像确诊的急诊主动脉夹层患者61例,对所有患者临床治疗进行回顾性分析。所有患者均通过超声心动图检查和多层螺旋CT平扫,对比分析两组诊断结果。结果:所有61例主动脉夹层患者中,总体异常61例,主动脉瓣异常41例,主动脉弓部异常44例,胸、腹主动脉异常45例,冠状动脉异常6例。多层螺旋CT诊断的总体异常、胸、腹主动脉异常以及冠状动脉异常诊断率均为100%,相比于超声心动图的91.8%、86.7%及0.0%更高,差异有统计学意义(P<0.05);两组在主动脉瓣异常、主动脉弓部异常诊断率之间的差异无统计学意义(P>0.05)。结论:超声心动图在诊断主动脉夹层时具有无创性、可重复性,且操作简便,能够对诊断主动脉弓部异常、DebakeyⅠ型主动脉瓣具有较高准确性。而多层螺旋CT相比于超声心动图具有更大优势,可进一步准确诊断胸、腹主动脉分支异常和冠状动脉异常等,具有更高临床诊断价值。
Objective: To compare the diagnostic value of multi-slice spiral CT and echocardiography in the diagnosis of aortic dissection. Methods: A total of 61 patients with acute aortic dissection confirmed by CT angiography in our hospital from December 2014 to December 2016 were retrospectively analyzed. All patients underwent echocardiography and multi-slice spiral CT scan, comparative analysis of two sets of diagnostic results. Results: Of the 61 patients with aortic dissection, there were 61 patients with abnormalities, 41 with aortic valve abnormalities, 44 with abnormal aortic arch, 45 with abnormal thoracic and abdominal aorta, and 6 with abnormal coronary arteries. The overall diagnosis of multi-slice spiral CT, chest, abdominal aortic abnormalities and coronary artery abnormalities were 100%, compared with 91.8%, 86.7% and 0.0% higher echocardiography, the difference was statistically significant ( P <0.05). There was no significant difference between the two groups in the diagnosis of aortic valve abnormality and aortic arch abnormality (P> 0.05). Conclusions: Echocardiography is noninvasive and reproducible in the diagnosis of aortic dissection, and is simple and easy to operate. It can diagnose aortic arch abnormality with high accuracy of Debakey Ⅰ aortic valve. Multi-slice spiral CT has more advantages than echocardiography, and can further diagnose abnormal thoracic and abdominal aorta branches and coronary artery abnormalities, which has a higher clinical diagnostic value.