Hayashi H, Kawamata H, Kumazaki T
Department of Radiology, Nippon Medical School.
Nihon Igaku Hoshasen Gakkai Zasshi. 1994 Nov 25;54(13):1217-24.
Thirty-four patients with acute aortic dissection with thrombosed false lumen were reviewed. In 4 cases (12%), the false lumens changed to the patent type. Changes in the false lumens were revealed by contrast-enhanced CT performed from day 2 to day 19 (mean, day 12.5) after the onset. The entry site was located at the descending aorta in 3 cases, and was unknown in 1 case. In 2 cases, the entry site corresponded with ulcer-like projections that had been pointed out at the thrombosed false lumen. One patient presented with moderate back pain when the false lumen changed, while the others were symptom free. During the follow-up period, 2 patients died of rupture of the false lumen. One patient was treated with a surgical operation. The patent false lumen became re-thrombosed in 1 patient. Although the majority of cases of thrombosed aortic dissection are considered to have a good prognosis, some cases change to the patent type without clinical symptoms. Radiologists should be aware of the unstable nature of the thrombosed type aortic dissection, and follow-up examinations should be performed at least once a week for three weeks after the onset of dissection.
对34例急性主动脉夹层伴血栓形成的假腔患者进行了回顾性研究。4例（12%）患者的假腔转变为通畅型。在发病后第2天至第19天（平均12.5天）进行的对比增强CT检查发现了假腔的变化。3例患者的破口位于降主动脉，1例患者的破口位置不明。2例患者的破口与血栓形成的假腔内指出的溃疡样突出部位相对应。1例患者在假腔转变时出现中度背痛，其他患者无症状。在随访期间，2例患者死于假腔破裂。1例患者接受了手术治疗。1例患者通畅的假腔再次形成血栓。虽然大多数血栓形成的主动脉夹层病例被认为预后良好，但一些病例在无临床症状的情况下转变为通畅型。放射科医生应意识到血栓形成型主动脉夹层的不稳定性质，并且在夹层发病后的三周内至少每周进行一次随访检查。
