Hayashi H, Onda M, Takagi R, Kawamata H, Watari J, Ichikawa T, Kumazaki T
Department of Radiology, Nippon Medical School.
Nihon Igaku Hoshasen Gakkai Zasshi. 1995 May;55(6):402-8.
Contrast-enhanced CT images in patients with acute or chronic aortic dissection were evaluated for the purpose of determining the clinical usefulness of "aortic cobwebs", which were originally reported by Williams et al. as an anatomical marker of the false lumen. Aortic cobwebs were detected in 13 of 44 cases (30%), demonstrating as low density structures in the false lumen continuing from the intimal flap. The aortic cobwebs were mainly linear in shape, and the size ranged from 5 x 1 to 15 x 3 mm (mean: 9 x 2 mm). Aortic cobwebs were more frequently demonstrated in chronic than in acute cases, and were more often detected in the abdominal aorta. Follow-up CT examinations of the cobwebs revealed no interval change in six cases, disappearance in three cases and thickening in one case. There was no significant correlation between the sequential changes in the cobwebs and dilatation or thrombus formation in the false lumen. Aortic cobwebs seem to represent partially residual bands of the aortic media incompletely sheared from the aortic wall during the initial processes of aortic dissection. These structures are considered to be a reliable anatomic marker and to be useful for CT identification of the false lumen in aortic dissection.
为了确定“主动脉蛛网”的临床应用价值，对急性或慢性主动脉夹层患者的增强CT图像进行了评估，“主动脉蛛网”最初由Williams等人报道，是假腔的一种解剖学标志。44例患者中有13例（30%）检测到主动脉蛛网，表现为从内膜瓣延续至假腔内的低密度结构。主动脉蛛网主要呈线性，大小范围为5×1至15×3mm（平均：9×2mm）。慢性病例中主动脉蛛网的显示频率高于急性病例，且在腹主动脉中更常被检测到。对蛛网的随访CT检查显示，6例无间隔变化，3例消失，1例增厚。蛛网的连续变化与假腔内的扩张或血栓形成之间无显著相关性。主动脉蛛网似乎代表了在主动脉夹层初始过程中未完全从主动脉壁剪切下来的主动脉中膜的部分残留带。这些结构被认为是一种可靠的解剖学标志，有助于CT识别主动脉夹层中的假腔。
