目的观察多层螺旋CT造影 (MSCTA)对主动脉壁间血肿(AIH)的诊断 及随访评价价值。方法 对14例AIH患者 的临床和随访资料进行回顾性分析，观 察AIH患者诊断及随访时的MSCTA影像特 点。结果 14例AIH患者Stanford A型3例 (21.43%)，Stanford B型11例(78.57%)； 主动脉壁新月型增厚12例(85.71%)，环 形增厚2例(14.29%)；可见主动脉壁钙 化斑块10例(71.43%)，钙化斑块内移9 例(64.29%)；可见主动脉壁溃疡龛影11 例(78.57%)，其中位于壁间血肿部位9 例(64.29%)，位于壁间血肿部位外2例 (14.29%)；可见内膜渗漏1例(7.14%)； 并发胸腔积液6例(42.86%)，胸腔积液合 并心包积液1例(7.14%)。12周时随访血 肿完全吸收11例(78.57%)，基本吸收2例 (14.29%)，明显吸收1例(7.14%)，吸收好 转0例(0.00%)，无改善0例(0.00%)。结论 MSCTA可全面、直观地显示AIH的各种影像 学征像，且为无创检查，重复性好，可及 时反映AIH治疗情况，对AIH的诊断及随访 检查有一定帮助。

Objective To observe the values of multi-slice spiral CT angiography (MSCTA) in the diagnosis and follow-up evaluation of aortic intramural hematoma (AIH). Methods The clinical and follow-up data of 14 AIH patients were retrospectively analyzed. The imaging features of MSCTA in diagnosis and follow-up of AIH were observed. Results Among the 14 cases of AIH patients, there were 3 cases (21.43%) with Stanford type A and 11 cases (78.57%) with Stanford type B. There were 12 cases (85.71%) of aortic crescent thickening and 2 cases (14.29%) of ring thickening. 10 cases (71.43%) were visible aortic wall calcification plaque and 9 cases (64.29%) were calcified plaque migration. There were 11 cases (78.57%) of canker ulceration in aorta, of which 9 cases (64.29%) were located in the hematoma of the wall and 2 cases (14.29%) were located outside the hematoma of the wall. Endometrial leakage was seen in 1 case (7.14%), pleural effusion in 6 cases (42.86%) and pleural effusion with pericardial effusion in 1 case (7.14%). At 12 weeks follow-up, 11 cases (78.57%) completely absorbed hematoma, and 2 cases (14.29%) basically absorbed and 1 case (7.14%) obviously absorbed, and 0 cases (0.00%) were with absorption improvement and 0 cases (0.00%) with no improvement. Conclusion MSCTA can display all kinds of imaging features of AIH comprehensively and intuitively, and it is a noninvasive examination with good repeatability, and it can reflect the treatment of AIH in time and is helpful to the diagnosis and follow-up examination of AIH.