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主动脉夹层的磁共振诊断:特别提及真假腔之间的交通口

[Magnetic resonance diagnosis of aortic dissection: with special reference to the communicating orifice between the true and false lumens].

作者信息

Mukohara N, Yoshida Y, Nakamura K

机构信息

Second Department of Surgery, Kobe University School of Medicine.

出版信息

J Cardiogr. 1986 Sep;16(3):607-26.

PMID:3655414
Abstract

Magnetic resonance imaging (MRI) was performed in thirty-one patients with aortic dissection to evaluate its usefulness in diagnosing the site of communicating orifice between the true and false lumens and the presence of retrograde dissection. MRI revealed the site of the entry as a defect in the intimal flap in the images of 12 of 15 patients (80%). The site of the communicating orifice between the true and false lumens in the abdominal aorta could be determined in six of eight patients (75%). MRI diagnosis of retrograde dissection was successful in three patients. Cross-sectional analysis of the abdominal aorta based on the location of the true lumen revealed that the celiac and superior mesenteric arteries tended to arise from the true lumen when the latter was situated in the anterior part of the abdominal aorta. The right and left renal arteries arose from the true lumen when it was positioned anterolaterally. In conclusion, MRI was a useful diagnostic method for aortic dissection, especially for determining the site of entry in the thoracic aorta. The changes in signal intensity in the false lumen provided useful information for locating the communicating orifice between the true and false lumens and for diagnosis of retrograde dissection. Cross-sectional analysis of dissection in the abdominal aorta was useful for predicting the branching of the main arteries from the true or false lumen.

摘要

对31例主动脉夹层患者进行了磁共振成像(MRI)检查,以评估其在诊断真假腔之间交通口部位及逆行夹层存在情况方面的效用。MRI在15例患者中的12例(80%)图像上显示入口部位为内膜瓣的缺损。在8例患者中的6例(75%)中可确定腹主动脉真假腔之间交通口的部位。3例患者的逆行夹层MRI诊断成功。基于真腔位置对腹主动脉进行横断面分析显示,当真腔位于腹主动脉前部时,腹腔干和肠系膜上动脉倾向于发自真腔。当真腔位于腹外侧时,左右肾动脉发自真腔。总之,MRI是诊断主动脉夹层的一种有用方法,尤其对于确定胸主动脉的入口部位。假腔内信号强度的变化为定位真假腔之间的交通口及诊断逆行夹层提供了有用信息。对腹主动脉夹层进行横断面分析有助于预测主要动脉发自真腔或假腔的情况。

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