Shiga Yuhei, Miura Shin-Ichiro, Kumagai Naoko, Mitsutake Ryoko, Iwata Atsushi, Nishikawa Hiroaki, Matsuo Kunihiro, Okabe Masanori, Saku Keijiro
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
Department of Emergency and Critical Care Medicine, Fukuoka University School of Medicine, Fukuoka, Japan.
J Cardiol Cases. 2011 Oct 4;5(1):e48-e50. doi: 10.1016/j.jccase.2011.09.002. eCollection 2012 Feb.
Coarctation of the aorta with aortic dissection is sometimes seen in cases of Turner syndrome, and most cases are type A aortic dissection, whereas coarctation of the aorta with type B aortic dissection is unusual. Only two cases of coarctation of the aorta presenting as aortic dissection have been reported in Japan, and only a few cases have been reported worldwide. We report here a case of coarctation of the aorta with some collaterals presenting as aortic dissection (type B) detected by 64-multidetector row computed tomography (MDCT). A 36-year-old man was brought to the emergency room complaining of sudden chest pain and back pain. Since he showed highly developed collaterals, he might never have exhibited symptoms or any limits on movement. Three-dimensional image reconstruction enabled detection of the coarctation of the aorta with some collaterals and aortic dissection in the best projection, and enabled assessment of precise anatomical relationship. In the present case, MDCT gave more useful information than cardiac catheterization for planning the surgical repair of coarctation of the aorta with some collaterals presenting as aortic dissection.
主动脉缩窄合并主动脉夹层有时可见于特纳综合征患者，且多数病例为A型主动脉夹层，而主动脉缩窄合并B型主动脉夹层则较为罕见。在日本，仅有两例主动脉缩窄表现为主动脉夹层的病例报道，全球范围内报道的病例也为数不多。我们在此报告一例通过64排多层螺旋CT（MDCT）检测到的主动脉缩窄合并一些侧支循环且表现为主动脉夹层（B型）的病例。一名36岁男性因突发胸痛和背痛被送往急诊室。由于他显示出高度发达的侧支循环，他可能从未出现过症状或运动受限。三维图像重建能够在最佳投影中检测到合并一些侧支循环的主动脉缩窄及主动脉夹层，并能够评估精确的解剖关系。在本病例中，对于计划手术修复合并表现为主动脉夹层的一些侧支循环的主动脉缩窄，MDCT比心导管检查提供了更有用的信息。
