Baur A, Stäbler A, Bittmann I, Marmarakis G, Reiser M
Institut für Radiologische Diagnostik Klinikum Grosshadern, München.
Rofo. 1998 Jun;168(6):550-6. doi: 10.1055/s-2007-1015279.
The aim was to present clinical findings and imaging criteria for patients with aortic ulcers of the thoracic aorta.
From 1993 to 1996 computed tomography of patients suffering from acute thoracic pain and suspected pathologies of the aorta were reviewed for penetrating aortic ulcers. Pathoanatomical correlation was done by autopsy in three cases and with intraoperative inspection in two cases. MRI was available in three patients and angiography in 5 patients.
9 patients with aortic ulcers could be identified. The imaging criteria in CT were: 1. Hyperdense wall thickening on unenhanced CT scans (medial haematoma). 2. Displaced intimal calcifications outlining the lumen. 3. Small contrast-filled ulcer. 4. Absence of a contrast-filled false lumen. In 4 of the 9 cases the aorta ascendens was affected. The clinical presentation is that of an elderly patient with acute onset of thoracic pain and generalised atherosclerosis due to hypertension and nicotine abuse.
Penetrating ulcers with haematoma of the media are a special case of aortic dissection, with different features on unenhanced and enhanced CT scans.
旨在阐述胸主动脉溃疡患者的临床发现及影像学标准。
回顾1993年至1996年期间因急性胸痛且疑似主动脉病变的患者的计算机断层扫描，以查找穿透性主动脉溃疡。3例通过尸检、2例通过术中检查进行病理解剖相关性分析。3例患者进行了磁共振成像检查，5例患者进行了血管造影检查。
共识别出9例主动脉溃疡患者。CT的影像学标准为：1. 平扫CT扫描时壁增厚呈高密度（中层血肿）。2. 内膜钙化移位勾勒出管腔轮廓。3. 小的造影剂充盈性溃疡。4. 无造影剂充盈的假腔。9例中有4例升主动脉受累。临床表现为老年患者，因高血压和吸烟导致急性胸痛发作并伴有全身性动脉粥样硬化。
伴有中层血肿的穿透性溃疡是主动脉夹层的一种特殊情况，在平扫和增强CT扫描上有不同特征。
