标题：主动脉夹层64排螺旋CT的诊断价值

      作者：林红东，周玉祥，肖俊强
    （惠州市中心人民医院放射科，广东 惠州 516001）

      卷次： 2013年24卷7期

      【摘要】 目的 探讨主动脉夹层在64排螺旋CT的影像特征，特别是对破口、真腔、假腔的显示。方法 54例
主动脉夹层患者行64排螺旋CT检查，图像数据进行三维重建后处理，并分析其影像特征。结果 按照DeBakey
分型，Ⅰ型14例，Ⅱ型4例，Ⅲ型36例；假腔呈新月形40例，半圆形9例，5例为圆形；真腔呈圆形40例，半圆形9
例，扁平形5例。平扫：6例假腔呈稍高密度，10例可见钙化内膜片向腔内移位，6例未移位内膜钙化位于真腔外
壁。动脉期强化特点：真、假腔同步明显强化23例，真腔强化程度大于假腔26例。静脉期强化特点：假腔密度大
于真腔46例，真、假腔密度相等3例，5例假腔不强化或小片状强化。49例可见内膜破口，5例未显示破口，破口
显示率约为90.7%。结论 64排螺旋CT可以明确主动脉夹层的诊断、分型、区分真假腔，详细评估受累范围、脏
器动脉供血情况，对指导临床治疗具有重要意义。

      【关键词】 主动脉夹层；真腔；假腔；64排VCT

      【中图分类号】 R445 【文献标识码】 A 【文章编号】 1003—6350（2013）07—0995—03


Value of 64-multislice spiral CT in the diagnosis of aortic dissection.
LIN Hong-dong, ZHOU Yu-xiang, XIAO
Jun-qiang. Department of Radiology, Huizhou Central People's Hospital, Huizhou, Huizhou 516001, Guangdong, CHINA

【Abstract】 Objective To study the CT features of aortic dissection, focusing on the display of true or false
lumen. Methods Fifty-four patients of aortic dissection were examined by 64-multislice spiral CT (64-MSCT), and
the CT imaging data was analyzed retrospectively. Results The fifty-four patients were classified as typeⅠ (14 pa-
tients), Type Ⅱ (4 patients) and Type Ⅲ (36 patients), based on Debakey classification. The false lumen was cres-
cent-shaped in 40 patients, circle-shaped in 5 patients, semicircle-shaped in 9 patients. Unenhanced CT showed high
density of false lumen in 6 patients and ingression of calcified plaque in 10 patients. Outer wall calcification of 6 cases
was only seen in ture lumen. On arterial enhanced phase, true lumen and false lumen were enhanced meanwhile in 23
patients. The density of true lumen was greater than false lumen in 26 patients. On venous enhanced phase, the density
of false lumen was greater than true lumen in 46 patients, 3 cases of true lumen density was similar to false lumen, 5
cases of false lumen were unenhanced. Entry site were clearly showed in 49 patients (90.7%), but not in 5 patients.
Conclusion 64-multislice spiral CT has great value in the diagnosis of aortic dissection, classification, differentia-
tion of fasle or true lumen, which provides significant guidance to clinical treatment.