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双源 CT 血管造影在急性 A 型主动脉夹层主动脉弓血管评估中的作用:42 例回顾性研究。

The Role of Dual-Source Computed Tomography Angiography in Evaluating the Aortic Arch Vessels in Acute Type A Aortic Dissection: A Retrospective Study of 42 Patients.

机构信息

Department of Radiology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian, China (mainland).

出版信息

Med Sci Monit. 2019 Dec 24;25:9933-9938. doi: 10.12659/MSM.919678.

Abstract

BACKGROUND This study aimed to investigate the role of dual-source computed tomography angiography (DSCTA) to evaluate the anatomy of the aortic arch vessels in patients with acute Type A aortic dissection (AD). MATERIAL AND METHODS A retrospective clinical study included 42 patients with acute Type A AD who underwent DSCTA and were treated in our hospital between January 2018 and December 2018. The findings were compared with a control group of 45 healthy individuals with hypertension and without aortic arch lesions. RESULTS The diagnostic accuracy of DSCTA in patients with acute Type A AD was almost 100%. The innominate artery was most frequently affected. The mean DSCTA imaging measurements for the root of the innominate artery, the left common carotid artery, and the left subclavian artery, in the coronal plane of the aortic arch, were 17.7±3.7 mm, 17.7±3.7 mm, and 12.9±3.1 mm, respectively. The angles formed by the origin of the three aortic arch branches vessels and the aortic arch were 70.5±10.2°, 58.5±15.5°, and 90.2±22.7°, respectively. In the transverse plane of the aortic arch, the mean angles were 110.5±22.3°, 100.3±15.2°, and 95.4±10.6°, respectively. These DSCTA imaging findings were significantly different in the patient group compared with the control group. CONCLUSIONS DCTA demonstrated that patients with Type A AD showed anatomic differences in the aortic arch vessels. These findings may help surgeons to develop treatment strategies and select the most appropriate vascular grafts and stents.

摘要

背景

本研究旨在探讨双源 CT 血管造影(DSCTA)在评估急性 A 型主动脉夹层(AD)患者主动脉弓血管解剖结构中的作用。

材料和方法

回顾性临床研究纳入 2018 年 1 月至 2018 年 12 月期间在我院接受 DSCTA 检查和治疗的 42 例急性 A 型 AD 患者。将结果与 45 例患有高血压且无主动脉弓病变的健康对照者进行比较。

结果

DSCTA 对急性 A 型 AD 患者的诊断准确率几乎达到 100%。无名动脉最常受累。主动脉弓冠状面无名动脉、左颈总动脉和左锁骨下动脉根部的平均 DSCTA 影像学测量值分别为 17.7±3.7mm、17.7±3.7mm 和 12.9±3.1mm。主动脉弓三个分支血管起源处与主动脉弓形成的夹角分别为 70.5±10.2°、58.5±15.5°和 90.2±22.7°。主动脉弓横断面平均角度分别为 110.5±22.3°、100.3±15.2°和 95.4±10.6°。这些 DSCTA 影像学发现与对照组相比,在患者组中差异有统计学意义。

结论

DCTA 显示 A 型 AD 患者主动脉弓血管存在解剖差异。这些发现可能有助于外科医生制定治疗策略并选择最合适的血管移植物和支架。

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