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多排 CT 主动脉夹层成像:影像学综述

Multidetector CT of Aortic Dissection: A Pictorial Review.

机构信息

Department of Radiology, City Hospital Campus, Nottingham University Hospitals NHS Trust, Hucknall Rd, Nottingham NG51PB, England.

出版信息

Radiographics. 2010 Mar;30(2):445-60. doi: 10.1148/rg.302095104.

Abstract

Aortic dissection is the most common acute emergency condition of the aorta and often has a fatal outcome. Outcome is determined by the type and extent of dissection and the presence of associated complications (eg, cerebral sequelae, aortic branch involvement, pericardial involvement, and visceral involvement), with early diagnosis and treatment being essential for improved prognosis. Aortic dissections are classified on the basis of the site of the intimal tear according to the Stanford classification system. Type A aortic dissection involves the ascending thoracic aorta and may extend into the descending aorta, whereas in a type B dissection the intimal tear is located distal to the left subclavian artery. Type A dissection typically requires urgent surgical intervention, whereas type B dissection can often be treated medically. Modern multidetector computed tomography (CT) is a fast, widely available imaging modality with high sensitivity and specificity. Multidetector CT allows the early recognition and characterization of aortic dissection as well as determination of the presence of any associated complications, findings that are essential for optimizing treatment and improving clinical outcomes.

摘要

主动脉夹层是主动脉最常见的急性危急病症,常导致致命后果。预后取决于夹层的类型和范围以及是否存在相关并发症(如脑后遗症、主动脉分支受累、心包受累和内脏受累),早期诊断和治疗对于改善预后至关重要。主动脉夹层根据斯坦福分类系统,根据内膜撕裂的部位进行分类。A型主动脉夹层累及升主动脉并可能延伸至降主动脉,而 B 型夹层的内膜撕裂位于左锁骨下动脉远端。A型夹层通常需要紧急手术干预,而 B 型夹层通常可以用药物治疗。现代多层螺旋 CT(CT)是一种快速、广泛应用的成像方式,具有高灵敏度和特异性。多层螺旋 CT 可早期识别和特征化主动脉夹层,并确定是否存在任何相关并发症,这些发现对于优化治疗和改善临床结局至关重要。

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