The Pulmonary Findings In Patients With Acute Aortic Dissection On Multidetector CT

Objective:To investigate pulmonary findings and their incidences in patients with acute aortic dissection on multidetector CT (MDCT). To assess the relationship with the treatment and prognosis.Methods and Materials:Seventy one cases with acute aortic dissection diagnosed with MDCT in Tianjin Medical University General Hospital from January2011to December2012, were included in this study. In total,71cases patients (male50,female21), aged from32to83years, and the mean age is (58.2±11.6) years. All71MDCT images were transported to GE AW4.4workstation, by mediastinal window (45HU,440HU) and lung window(-700HU,1500HU) were observed and recorded, the characteristics and incidences of pulmonary findings were analyzed. The difference of pulmonary findings between Stanford A type and Stanford B type was compared,41cases Stanford A type patients while30cases Stanford B type patients. The changes of pulmonary findings after endovascular stent-graft implantation in aorta (22cases) and conservation therapy (14cases) were also discussed.Results:71cases (100%) patients with acute aortic dissection had lung pathological changes,45cases (63.4%) patients had two or more pulmonary changes. The most common findings were interlobular septal thickening (51cases,71.8%), pericardial effusion and/or cardiac enlargement(28cases,39.4%), pleural effusion(18cases,25.4%), and atelectasis (13cases,18.3%) on the MDCT of such patients, and the incidences of these findings were relatively high. In the comparison between Stanford A type and Stanford B type patients, the difference in the incidence of pericardial effusion and/or cardiac enlargement was significantly signficant, in Stanford A type this finding being more than that in Stanford B type [51.2%(21/41cases) vs.23.3%(7/30cases), P=0.011]. There were no significant differences in the various pulmonary changes before and after endovascular stent-graft implantation in aorta and conservative treatment (all P>0.05).Conclusion:MDCT’s value to the diagnosis of aortic dissection had confirmed. By MDCT scan can provide high quality lung images at the same time, realize the change of observation and diagnosis to the lungs, help to correct clinical treatment plan, improve the clinical value of MDCT in the diagnosis of aortic dissection and follow-up.Various pulmonary findings may accompany with acute aortic dissection. These findings and their clinical significance should be further investigated.