目的 探讨超声、血管多层螺旋 CT(CTA)联合诊断在StanfordA型主动脉 夹层分型中的应用价值。方法 对78例高 度怀疑StanfordA型主动脉夹层患者分别 行超声和CTA检查，了解其分型，并以手 术结果作为“金标准”。结果 超声、CTA 联合诊断StanfordA型主动脉夹层的准确 率、敏感性分别为93.59%、100.0%明显高 于超声(69.23%、72.58%)、CTA(74.36%、 88.71%)(P＜0.05)；特异性无差异(P＞ 0.05)；三组联合诊断A1型、A2型、A3型 的准确率无差异(P＞0.05)；CTA显示内膜 片、内膜片累及范围、假腔血栓、主动脉 弓受累、动脉弓分支受累的几率高于超 声，显示心功能降低、主动脉反流的几率 明显低于超声(P＜0.05)。结论 超声和 CTA联合诊断StanfordA型主动脉夹层准确 率及分型准确率较高，还可了解内膜片及 其累及范围、假腔血栓等情况。

Objective To investigate the application value of ultrasound and vascular multi-slice spiral CT (CTA) combined diagnosis in typing of Stanford A aortic dissection. Methods 78 cases of patients with highly suspected Stanford A type aortic dissection were examined by ultrasound and CTA to know their types. The operation results were taken as the golden standard. Results The accuracy and sensitivity of ultrasound and CTA in the diagnosis of Stanford A type aortic dissection (93.59%, 100%) were significantly higher than that of ultrasound (69.23%, 72.58%) and CTA (74.36%, 88.71%) (P<0.05). There was no difference of specificity (P>0.05). There were no differences between the three groups in the combined diagnosis of A1 type, A2 type and A3 type (P>0.05). The probabilities of CTA showing intimal flap, scope involved by intimal flap, false lumen thrombus, aortic arch involvement and aortic arch branches involvement were higher than those of ultrasound while the probabilities in showing decreased heart function and aortic regurgitation were significantly lower than those of ultrasound (P<0.05). Conclusion The accuracy and typing accuracy of ultrasound and CTA in combined diagnosis of Stanford A type aortic dissection are relatively higher, which also can help to know the intimal flap and involved scope and false lumen thrombus, etc..