Li Tao, Zhao Shaohong, Li Jinfeng, Huang Zili, Luo Chuncai, Yang Li
Department of Radiology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
Chin Med Sci J. 2017 Apr 10;32(1):28-3. doi: 10.24920/j1001-9242.2007.004.
Objective To investigate the role of multi-detector computed tomography (CT) in the diagnosis and classification of isolated spontaneous superior mesenteric artery dissection (ISSMAD). Methods From July 2012 to December 2016, 30 consecutive patients with ISSMAD underwent CT scan at least two times. We retrospectively summarized the clinical characteristics and CT findings of them. The stenosis ratio of true lumen was compared between the patients without bowel ischemia and ones with bowel ischemia. Results There were 5 cases of type I ISSMAD, 14 cases of type 2, 1 case of type 3, 7 cases of type 4 and 3 cases of type V. Intestinal ischemia occurred in 5 patients. The stenosis ratio of true lumen in the patients without bowel ischemia was lower than that with bowel ischemia (45.6% vs. 76.0%, t=-14.5, P=0.000). Five patients with intestinal ischemia underwent superior mesenteric artery stenting and others received conservative therapy. The abdominal pain was alleviated for all the patients after treatment. Follow-up was complete in 30 cases. Follow-up CT angiography of superior mesenteric artery showed dissection remodeling in 12 patients. Conclusion Multi-detector CT is a valuable method in diagnosis and classification of ISSMAD and monitoring the changes of dissection.
目的 探讨多排螺旋计算机断层扫描（CT）在孤立性自发性肠系膜上动脉夹层（ISSMAD）诊断及分型中的作用。方法 回顾性分析2012年7月至2016年12月期间连续收治的30例ISSMAD患者，均接受至少两次CT扫描，总结其临床特征及CT表现，并比较无肠缺血患者与有肠缺血患者真腔狭窄率。结果 Ⅰ型ISSMAD 5例，Ⅱ型14例，Ⅲ型1例，Ⅳ型7例，Ⅴ型3例。5例患者发生肠缺血。无肠缺血患者真腔狭窄率低于有肠缺血患者（45.6%比76.0%，t=-14.5，P=0.000）。5例肠缺血患者行肠系膜上动脉支架置入术，其余患者接受保守治疗，所有患者治疗后腹痛均缓解。30例患者均获完整随访，随访期肠系膜上动脉CT血管造影显示12例患者夹层重塑。结论 多排螺旋CT是ISSMAD诊断、分型及监测夹层变化的重要手段。
