Di Cesare E, Costanzi A, Fedele F, Di Renzi P, D'Eusanio G, Lupattelli L, Passariello R
Department of Radiology, University of L'Aquila, Italy.
Magn Reson Imaging. 1996;14(10):1149-56. doi: 10.1016/s0730-725x(96)00221-4.
In most cases, surgery of aortic dissections repairs only the ascending portion of the aorta, leaving a residual dissection in the arch and descending aorta. We studied 17 patients operated upon for type A aortic dissection. A total of 42 magnetic resonance imaging (MRI) examinations were performed, with two to five studies per patient (mean 2.47). The studies were done between 5 weeks and 47 months (mean 17.5 months) after surgery. The patients were evaluated by MRI using gated spin-echo and gradient-echo sequences on axial and oblique sagittal views, and in selected cases, coronal views. A high incidence of abnormalities was observed. Pericardial hematoma was observed in 11% of cases, aortic and branch involvement in 41%, abdominal aortic branch involvement in 47%, dilatation of native aorta in 58%, and extension of dissection in 10%. New complications were detected during follow-up in 53% of patients. MRI was helpful in the follow-up of patients operated upon for aortic dissections, owing to its noninvasiveness and multiplanarity. By means of this technique, it was possible to obtain information about the natural history of the disease, as well as information useful for subsequent treatment.
在大多数情况下，主动脉夹层手术仅修复主动脉升部，而在主动脉弓和降主动脉处留下残余夹层。我们研究了17例接受A型主动脉夹层手术的患者。共进行了42次磁共振成像（MRI）检查，每位患者进行了2至5次检查（平均2.47次）。这些检查在术后5周和47个月（平均17.5个月）之间进行。使用门控自旋回波和梯度回波序列在轴位和斜矢状位视图上对患者进行MRI评估，在选定病例中还包括冠状位视图。观察到异常的发生率很高。11%的病例观察到心包血肿，41%的病例观察到主动脉及其分支受累，47%的病例观察到腹主动脉分支受累，58%的病例观察到主动脉扩张，10%的病例观察到夹层扩展。53%的患者在随访期间发现了新的并发症。MRI因其无创性和多平面性，有助于对接受主动脉夹层手术的患者进行随访。通过这项技术，可以获得有关疾病自然史的信息，以及对后续治疗有用的信息。
