自发性孤立性腹腔干夹层的MSCT血管成像研究
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摘要
目的探讨自发性腹腔干夹层的MSCT血管造影表现及其对临床诊断的价值。方法回顾性分析27例自发性腹腔干夹层患者的临床及MSCT血管造影表现。结果 22例腹腔干血管显示了破口、内膜片及真假腔,2例腹腔干夹层血管钙化,1例可见钙化内移, 4例腹腔干夹层累及分支,1例合并脾梗死。27例夹层者夹层部位均有血管增粗表现,血管粗约0.9～1.9cm。符合Sakamoto Ⅰ型表现13例;Sakamoto Ⅱ型9例;Sakamoto Ⅲ型2例,Sakamoto Ⅳ型3例。结论 MSCT血管成像能敏感地显示腹腔干夹层的病理改变,可作为其诊断和随访的首选。
Objective To investigate the CT imaging features of spontaneous isolated celiac artery dissection(SICAD) and to assess the value of multislice spiral CT angiography in the diagnosis of SICAD. Methods The clinical and MSCT angiography manifestations of 27 patients with SICAD were retrospectively analyzed. Results Orifice of dissection, intimal plaque, true and false lumen were displayed in 22 celiac artery. Intimal calcification was seen in 2 cases, and calcification ingression in 1 case. The branch was involved in 4 cases, 1 case with splenic infarction. In all cases, the vessels were thickened at the site of dissection(0.9～1.9 cm). There were sakamoto type Ⅰ(n=13), Sakamoto type Ⅱ(n=9), Sakamoto type Ⅲ(n=2), Sakamoto type Ⅳ(n=3). Conclusion CTA can display SICAD clearly, which might be used as the first method for diagnosis and follow-up.
Objective To investigate the CT imaging features of spontaneous isolated celiac artery dissection(SICAD) and to assess the value of multislice spiral CT angiography in the diagnosis of SICAD. Methods The clinical and MSCT angiography manifestations of 27 patients with SICAD were retrospectively analyzed. Results Orifice of dissection, intimal plaque, true and false lumen were displayed in 22 celiac artery. Intimal calcification was seen in 2 cases, and calcification ingression in 1 case. The branch was involved in 4 cases, 1 case with splenic infarction. In all cases, the vessels were thickened at the site of dissection(0.9～1.9 cm). There were sakamoto type Ⅰ(n=13), Sakamoto type Ⅱ(n=9), Sakamoto type Ⅲ(n=2), Sakamoto type Ⅳ(n=3). Conclusion CTA can display SICAD clearly, which might be used as the first method for diagnosis and follow-up.
引文
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[10] Tana M,Tana C,Schiavone C,et al.Spontaneous dissection of the celiac artery in the young:a case report and systematic review of the literature [J].Hosp Pract,2017,45(5):258-264.
[11] Silveste J,Sardinha WE,Piazzalunga M,et al.Isolated dissection of the celiac artery:a case report [J].J Vasc Bras,2010,9(3):152-155.
[2] Kim SR,Park TK,Choi SH,et al.Natural history of spontaneous isolated celiac artery dissection after conservative treatment [J].J Vasc Surg,2018,14(1):75-77.
[3] Sakamoto I,Ogawa Y,Sueyoshi E,et al.Imaging appearances amd management of isolated spontaneous dissection of the superior mesenteric artery [J].Eur J Radiol,2007,64(1):103-110.
[4] 宁辉,张龙江.自发性腹腔干夹层的MSCT血管成像研究[J].放射学实践,2015,30(9):940-943.
[5] 孙捷,张鸿坤.自发性孤立性腹腔干动脉夹层的形态学分型和治疗进展[J].浙江医学,2017,39(19):1627-1628.
[6] Obon-Dent M,Shabaneh B,Dougheay KG,et al.Spontaneous celiac artery dissection case report and literature review [J].Tex Heart Inst J,2012,39(5):703-706.
[7] D'Ambrosio N,Friedman B,Siegel D,et al.Spontaneous isolated dissection of the celiac artery:CT findings in adults [J].AJR,2007,188(6):506-511.
[8] Glehen O,Feugier P,Aleksic Y,et al.Spontaneous dissection of the celiac artery [J].Ann Vasc Surg,2001,15(6):687-692.
[9] 王礼同,李澄,蔡玉建.自发性孤立性肠系膜上动脉夹层MSCT血管成像研究[J].放射学实践,2013,28(7):779-783.
[10] Tana M,Tana C,Schiavone C,et al.Spontaneous dissection of the celiac artery in the young:a case report and systematic review of the literature [J].Hosp Pract,2017,45(5):258-264.
[11] Silveste J,Sardinha WE,Piazzalunga M,et al.Isolated dissection of the celiac artery:a case report [J].J Vasc Bras,2010,9(3):152-155.