目的观察主动脉Ⅲ型夹层(AD) 覆膜支架介入治疗前后64排螺旋CT血管造 影技术(CTA)的随访结果。方法 选取我 院2007年8月至2012年9月46例主动脉Ⅲ型 夹层患者为研究对象，所选患者均采取夹 层覆膜支架介入治疗，于术前、术后进行 CTA诊断，分析CTA对主动脉夹层术前的诊 断价值以及用于术后随访的可行性。结 果 术前：46例患者均经CT增强扫描，确 诊为主动脉夹层，且真、假腔区分准确， 对破口、数量及内膜片的显像清晰，可见 受累血管血流情况以及周围器官、组织的 血供情况，Stanford分级：A型7例，B型 39例，破口数量52个，40例单破口，6例 双破口，受累动脉包括头臂干、腹部分 支、髂内动脉、髂总动脉及左颈总动脉， 共48支受累；术后：随访半年，无死亡患 者，48支受累分支，13支受累分支修复， 29支缓解，6例患者左肾萎缩。结论 64层 螺旋CT可实现AD的快速诊断，且准确率较 高，联合后期处理技术可清晰观察AD患者 破口、血管分布等情况，可为手术治疗提 供指导，且用于手术后远期随访无创、便 捷，具有较高的临床应用价值。

Objective To observe the follow-up results of 64 slice spiral CT angiography (CTA) before and after interventional therapy of type Ⅲ aortic dissection (AD) with covered stent. Methods 46 patients with type Ⅲ aortic dissection in our hospital from August 2007 to September 2012 were selected as the research objects. The selected patients were treated with dissection covered stent interventional therapy, and CTA was performed before and after operation. The diagnostic value of CTA in aortic dissection before operation and the feasibility of application in postoperative follow-up were analyzed. Results Before operation: 46 patients were canned by enhanced CT scan, diagnosed as aortic dissection, and true and false lumen were accurately distinguished. The images of break, quantity and intimal flap were clear and the involvement of vascular blood flow and blood supply of surrounding organs and tissues were visible. Stanford classification: 7 cases of type A, 39 cases of type B. The number of break was 52, including 40 cases of single break and 6 cases of double break. The involved arteries included brachiocephalic trunk, abdominal branch, internal iliac artery, iliac artery and left common carotid artery and a total of 48 branches were involved; After operation: With half year of follow-up, there was no death. 48 branches were involved, 13 involved branches were repaired and 29 cases were relieved. 6 cases of patients were with left renal atrophy. Conclusion 64 slice spiral CT can realize rapid diagnosis of AD and the accuracy is higher. Combined with post processing technology, the break and vascular distribution in patients with AD can clearly be observed, which can provide guidance for surgical treatment and can be used for postoperative long-term follow-up, noninvasive and convenient. It is of high clinical application value.