Cullenward M J, Scanlan K A, Pozniak M A, Acher C A
Radiology. 1986 Apr;159(1):75-82. doi: 10.1148/radiology.159.1.3513252.
Inflammatory aneurysms represent a distinct surgical entity with a reported incidence varying from 5% to 23% of all abdominal aortic aneurysms. Surgical repair of inflammatory aneurysms is associated with a higher morbidity and mortality than is repair of simple aortic aneurysms. Complicated cases require suprarenal aortic control, and the surgeon must be forewarned to maximize the chance for successful aneurysm repair. Preoperative diagnosis of this entity by cross-sectional imaging facilitates improved planning of the operative approach and permits the institution of preoperative steroid treatment to reduce the volume of the periaortic fibrotic mass. Ultrasound demonstrates the inflammatory process as a hypoechoic mass surrounding the intensely echogenic, thickened aortic wall. Computed tomography reveals a thickened, often calcified aortic wall and a mass of periaortic inflammatory tissue. Dynamic scanning reveals rapid intraluminal enhancement, slightly delayed enhancement of the inflammatory mass, and nonenhancement of the thick fibrous adventitia.
炎性动脉瘤是一种独特的外科疾病实体，据报道在所有腹主动脉瘤中发病率为5%至23%。与单纯主动脉瘤修复相比，炎性动脉瘤的手术修复与更高的发病率和死亡率相关。复杂病例需要进行肾上主动脉控制，必须提前告知外科医生，以最大限度地提高动脉瘤修复成功的几率。通过横断面成像对该疾病进行术前诊断有助于改进手术入路的规划，并允许采用术前类固醇治疗以减少主动脉周围纤维化肿块的体积。超声显示炎症过程为围绕强回声、增厚主动脉壁的低回声肿块。计算机断层扫描显示主动脉壁增厚，常伴有钙化，以及主动脉周围炎性组织肿块。动态扫描显示管腔内快速强化，炎性肿块强化稍延迟，厚纤维外膜无强化。
