| Objective: To explore the value of multislice spiral CT angiography in the diagnosis and clinical application of acute aortic syndrome.Methods: In this study,we selected 70 patients diagnosed with acute aortic syndrome from January 2016 to December 2017 in Changsha Central Hospital,and retrospectively analyzed the imaging and clinical data of all cases.The original image of the case was transferred to the matching GE Advantage Windows 4.5(AW4.5)3D reconstruction workstation and the Add/Sub software was used for post-processing.All CT raw image data were processed by a physician,then the original and post-processing image data were analyzed and diagnosed.One chief physician and one deputy chief physician reviewed and corrected the results.Discuss and discuss the results.Detailed records of various types of lesions.Finally,statistical analysis was performed using SPSS 18.0 software.Results: There were 70 eligible patients in this study,including 43 males and 27 females.Among the 70 patients,the oldest was 90 years old and the youngest was 34 years old,with an average age of 59.28±11.41 years.1.There were 42 cases of aortic dissection(13 cases of Stanford type A and 29 cases of type B);19 cases of aortic intramural hematoma,6 cases of penetrating atherosclerotic ulcer,and 3 cases of unstable aortic aneurysm.2.A total of 42 cases of aortic dissection.All cases showed true and false double-lumen and internal-membrane flaps.29(69.0%)cases showed clear tears,5 were suspiciously displayed,and 8 cases were not clearly shown.26(61.9%)cases of true and false lumens were parallel and 16(38.1%)cases of false lumens were wrapped spirally around the true lumen.There were no mural thrombi in all cases.In 17 cases,there were mural thrombi in the false lumen,and most of them were in the proximal part of the false lumen.19(45.2%)cases of aortic main branch vessel involvement: 3 cases of brachiocephalic involvement,2 cases of left common carotid artery involvement,6 cases of left subclavian artery involvement,1 case of celiac dry artery involvement,2 cases of superior mesenteric artery involvement,Renal artery involvement in 4 cases,common iliac artery involvement in 15 cases.The maximum diameter of the aortic lumen was 53.62±12.85mm(type A)and 47.63±15.21mm(type B),respectively,P<0.05,and the difference was statistically significant.The ratio of false lumen diameter to true lumen diameter was 0.62±0.98(type A)and 1.18±0.37(type B),respectively;P<0.05,and the difference was statistically significant.3.A total of 19 cases of Aortic intramural hematoma patients,including type A 5 cases(26.3%),B type 14 cases(73.7%).In 16 cases(84.2%),the hematoma showed a thickening of the astral shape,and 3 cases(15.8%)showed an annular thickening.There were 9 cases(47.4%)of combined PAU in IMH,which showed a total of 26 ulcers.The thickness of hematoma was 13.27±3.61mm(Type A)and 12.63±3.53mm(Type B),P>0.05,and the difference was not statistically significant.The diameters of affected lumens were 54.57±4.39(type A)and 46.82±4.06(type B)respectively,P<0.05,and the difference was statistically significant.4.Simple aortic penetrating atherosclerotic ulcers were found in 6 cases and 3 cases were solitary.3 cases were multiple.A total of 10 ulcers occurred,one of which occurred at the ascending aorta and the remaining 9 at the descending aortic arch.There were 2 cases of PAU combined in the aortic dissection,showing 5 ulcers;9 cases of PAU combined in IMH showed 26 ulcers.Complex PAU refers to PAU combined in AD and IMH.Among them,3 occur at the ascending aorta,and the rest 28 occur at the descending portion of the aortic arch.Simple and complex PAU ulcer site,P> 0.05,the difference was not statistically significant.Conclusion:(1)Multi-slice spiral CT angiography combined with image post-processing technology can accurately display the characteristics of various lesions of acute aortic syndrome and achieve the purpose of qualitative and quantitative diagnosis of acute aortic syndrome;(2)In the acute aortic dissection,the ratios of the maximum diameter of the aorta and the ratio of the false lumen to the true lumen in the type A and B were statistically significant.Among them,the largest diameter of the aorta is larger than the type B;(3)Hematoma in the aortic wall,and the difference in the diameter of the involved lumen in the type A and B was statistically significant.Among them,the largest diameter of the aorta is larger than the type B. |
PDF Full Text Request