Godwin J D, Breiman R S, Speckman J M
J Comput Assist Tomogr. 1982 Aug;6(4):750-6. doi: 10.1097/00004728-198208000-00015.
Several conditions can lead to either false positive or false negative diagnoses of aortic dissection by computed tomography (CT) with intravenous administration of contrast medium. Insufficient contrast enhancement may cause intimal flaps to be missed, leading to a false negative diagnosis. False positive diagnoses result when extraaortic structures (e.g., mediastinal veins, pericardium, thickened pleura, and lung) are mistaken for false channels in the aorta. Superimposition of structures in thick CT slices may cause intimal calcifications to appear displaced. Streak artifacts across the descending aorta can resemble double aortic channels or intimal flaps. Fusiform aneurysms with thrombus are often hard to distinguish from thrombosed dissections by CT as well as by aortography.
几种情况可导致通过静脉注射造影剂的计算机断层扫描（CT）对主动脉夹层做出假阳性或假阴性诊断。造影增强不足可能导致内膜瓣漏诊，从而导致假阴性诊断。当主动脉外结构（如纵隔静脉、心包、增厚的胸膜和肺）被误认为是主动脉内的假腔时，就会出现假阳性诊断。厚层CT切片中结构的重叠可能导致内膜钙化出现移位。降主动脉上的条纹伪影可能类似于双主动脉通道或内膜瓣。有血栓的梭形动脉瘤通过CT以及主动脉造影往往也很难与有血栓形成的夹层相区分。
