论著-头颈部
64排CTA与超声心动图在诊断主动脉夹层中的应用
作者:员小利1 井海云1 王 丹1 荆宏峰2
所属单位:1.郑州大学附属郑州中心医院心内 五科 (河南 郑州 450000) 2.郑州大学附属郑州中心医院放射 科 (河南 郑州 450000)
PDF摘要
目的 探讨64排CT血管成像(CTA) 与超声心电动图在主动脉夹层的应用及 诊断价值。方法 选择2015年3月-2018年 3月在我院确诊为主动脉夹层患者57例 进行回顾性分析,所有患者均使用64排 CTA、超声心动图检查,观察两种诊断方 式诊断异常结果(总体异常、主动脉弓部 异常、主动脉瓣膜异常、胸及腹主动脉 异常、冠状动脉异常)、DeBakey分型(Ⅰ 型、Ⅱ型、Ⅲ型)及Stanford分型(A型、B 型)的诊断情况。结果 64排CTA、超声心 电动图对总体异常、主动脉瓣膜异常检 出率,差异无统计学意义(P>0.05);超 声心电动图对主动脉弓部异常检出率高于 64排CTA(P<0.05),64排CTA冠状对动脉 异常、胸及腹主动脉异常检出率高于超声 心电动图(P<0.05)。64排CTA、超声心电 动图对DeBakey Ⅰ型、DeBakey Ⅱ型、 Stanford A型检出率,差异无统计学意义 (P>0.05);64排CTA冠状对DeBakey Ⅲ 型、Stanford B型检出率高于超声心电动 图(P<0.05)。结论 两种诊断方式的临床 诊断均存在各自缺陷,但64排CTA与超声 心动图比较诊断优势明显,临床使用价值 相对较高。
Objective To explore the application and diagnostic value of 64-slice CT angiography (CTA) and ultrasonic cardiogram in the diagnosis of aortic dissection. Methods A total of 57 cases of aortic dissection diagnosed in our hospital from March 2015 to March 2018 were analyzed retrospectively. All patients were given 64-slice CTA and ultrasonic cardiogram to observe the abnormal diagnostic results of the two diagnostic methods (overall abnormalities, aortic arch abnormalities, aortic valve abnormalities, thoracic and abdominal aortic abnormalities, coronary artery abnormalities), DeBakey classification (type I, type II, type III) and Stanford classification (type A, type B). Results There were no significant differences in the overall abnormalities and aortic valve abnormalities between 64-slice CTA and ultrasonic cardiogram (P>0.05). The detection rate of abnormal aortic arch of ultrasonic cardiogram was higher than that of 64-slice CTA (P<0.05), and the detection rates of coronary artery abnormalities, thoracic and abdominal aortic abnormalities of 64-slice CTA were higher than those of ultrasonic cardiogram (P<0.05). There were no significant differences in the detection rates of DeBakey type I, DeBakey type II and Stanford type A between 64-slice CTA and ultrasonic cardiogram (P>0.05). The detection rates of DeBakey type III and Stanford type B of 64-slice CTA were higher than those of ultrasonic cardiogram (P<0.05). Conclusion There are certain defects in the clinical diagnosis of the two diagnostic methods, but the 64-slice CTA has obvious advantages than ultrasonic cardiogram, and it has relatively high clinical application value.
【关键词】64排CT血管成像;超声心动 图;主动脉夹层
【中图分类号】R445
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2019.02.007
前言
主动脉夹层是动脉腔内血液经动脉内膜撕裂口进入主动脉中层形 成血肿,导致主动脉真、假两腔出现分离的状态,发病率较低,但病 起急且病情凶险,病情发展迅速,死亡率高,是临床上危害较严重的 心血管疾病之一[1]。据不完全统计,主动脉夹层瘤患者24h内死亡率约 为25%~38%,48h内死亡率高达50%,若经及时手术或药物治疗,能有 效提高患者生存率,因此早期诊断对患者预后尤为重要[2]。主动脉夹 层临床首选诊断方式为影像学检查,其中超声心动图是首选无创检查 方式,而多层螺旋CT血管成像则能快速且高分辨成像等优势被广泛应 用。本文对我院收治的主动脉夹层患者进行回顾性研究,观察其在64 排多层螺旋CT血管成像、超声心动图诊断价值,现将研究情况报道如 下。
中国CT和MRI杂志
第17卷, 第 2 期
2019年02月
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