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[治疗后胸主动脉:CT与MR成像特征]

[Post treatment thoracic aorta: CT and MR imaging features].

作者信息

Rodière M, Michoud M, Monnin-Bares V, Thony F, Ferretti G

机构信息

Centre Hospitalier Universitaire de Grenoble, BP 217, 38043 Grenoble cedex 09, France.

出版信息

J Radiol. 2010 May;91(5 Pt 2):657-63. doi: 10.1016/s0221-0363(10)70082-2.

Abstract

Follow-up after thoracic aortic repair relies on CT and MR imaging in order to detect complications from the treatment or underlying pathology. Following prosthetic repair of the ascending aorta, peri-prosthetic hematoma and anastomotic complications (leak, false aneurysm, peri-prosthetic circulation) should be excluded. Following treatment with a covered stent, the location of the prosthesis and its skeleton should be evaluated and endo-leaks and wall defects should be excluded. Following treatment of a dissection, there often is persistent flow in the false lumen. The entry points into the false lumen should be identified. The caliber of the aorta at different levels should be assessed. Signs of ischemia (static and dynamic) and acute complications should be excluded in patients with acute chest pain. Atherosclerosis and dysplastic conditions may affect other segments of the aorta (aneurysm, dissection, hematoma). Follow-up is performed with CT, if possible, when high-resolution evaluation is required, of with MRI in other cases. Follow-up is obtained on a yearly basis or twice a year when an evolutive process is identified. It is performed every two to five years when the risk is low. Follow-up should be suggested by the radiologist.

摘要

胸主动脉修复术后的随访依赖于CT和磁共振成像,以便检测治疗引起的并发症或潜在病变。在升主动脉进行人工修复后,应排除人工血管周围血肿和吻合口并发症(渗漏、假性动脉瘤、人工血管周围循环)。在使用覆膜支架治疗后,应评估假体的位置及其支架,并排除内漏和管壁缺损。在治疗夹层后,假腔内通常会持续存在血流。应确定进入假腔的入口点。应评估不同水平主动脉的管径。对于急性胸痛患者,应排除缺血迹象(静态和动态)以及急性并发症。动脉粥样硬化和发育异常情况可能影响主动脉的其他节段(动脉瘤、夹层、血肿)。如果需要进行高分辨率评估,尽可能使用CT进行随访,其他情况下则使用MRI。当确定存在进展性病变时,每年或每年两次进行随访。当风险较低时,每两到五年进行一次随访。随访应由放射科医生建议进行。

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