目的 探讨心脏螺旋CT血管造影 成像(CTA)增强技术对主动脉夹层(AD) 与主动脉壁内血肿(IMH)的鉴别准确性 差异。方法 选取2011年10月-2015年5月 于我院治疗且经数字减影血管造影(DSA) 检查确诊的58例AD患者为研究对象，均 予以DSA及心脏CTA检查，以DSA检查结 果为“金标准”评估心脏CTA检查在AD 及IMH鉴别诊断中的准确性。结果 DSA 检查结果显示,58例确诊AD者中DeBakey Ⅰ型17例(29.3%)，DeBakey Ⅱ型6例 (10.3%)，DeBakey Ⅲ型25例(43.1%)， IMH 10例(17.2%)。CTA增强扫描鉴别诊 断结果显示，AD的鉴别诊断准确率为 96.6%(56/58)；IMH的鉴别诊断准确率为 80.0%(8/10)。结论 心脏CTA增强扫描具 有无创、安全、便捷、操作性强、鉴别准 确率突出等优势，在AD和IMH的鉴别诊断 中具有较高应用价值。

Objective To investigate the differences in the accuracy of cardiac spiral CT angiography (CTA) in the differential diagnosis of aortic dissection (AD) and aortic intramural hematoma (IMH). Methods 58 patients with AD confirmed by digital subtraction angiography (DSA) who were treated in our hospital between October 2011 and May 2015 were selected as study subjects. All the patients underwent DSA and cardiac CTA examination. The results of DSA were taken as the golden standard to evaluate the accuracy of CTA in the differential diagnosis of AD and in the differential diagnosis of AD and IMH. Results The results of DSA showed that among the 58 patients diagnosed with AD, 17 cases (29.3%) were DeBakeyⅠtype, 6 cases (10.3%) DeBakey II type, 25 cases (43.1%) DeBakey Ⅲtype and 10 cases (17.2%) IMH type. The results of CTA enhanced scan differential diagnosis showed that the accuracy in differential diagnosis of AD was 96.6% (56/58) and of IMH was 80% (8/10). Conclusion Cardiac CTA enhanced scan is with advantages such as noninvasive, safe, convenient, strong operability and high accuracy of differential diagnosis, etc.. It is of relatively higher application value in the differential diagnosis of AD and IMH.