Thoracic Aotra Pseudoaneurysms Of CT Diagnosis And Therapeutic Strategy

Objective:According to the examination and follow-up of51patients, who have beendiagnosed thoracic aorta pseudoaneurysms in our hospital, we will investigate theimaging behavior of thoracic aorta pseudoaneurysms, and will evaluate the diagnosisvalue of aorta scan and CTA scanning in this disease. Discussing treatment of thisillness: feasibility and efficacy of the treatment for intracavitary aneurysm repairementof thoracic aorta pseudoaneurysms.Thoracic aorta pseudoaneurysms is a rare aortic disease, which has no real vesselwall structure. The lesion is usually associated with aortic atherosclerosis, aorticpenetrating ulcer and aortic intramural hematoma. The causes generally are injury,atherosclerosis, iatrogenic infection, autoimmune disease, or pipe damage and aorticatypical interlayer conversion, etc. Due to the special position of thoracic aortapseudoaneurysms, rupture of it is very dangerous. Therefore, early diagnosis andpostoperative treatment of thoracic aorta pseudoaneurysms has great clinicalsignificance. The traditional method of treatment for thoracic aorta pseudoaneurysmsaneurysm is resection and artificial vascular replacement, but because of the age,trauma, bleeding, nervous system damage, lung injury and other risks and complications,lost the opportunity of treatment. Recent years, with the development of interventionaltreatment use endovascular repairement, more and more lumen interventional therapy isused as the treatment of thoracic aorta pseudoaneurysms. We retrospective analyzed theclinical data of patients in our hospital in nearly4years, analysis the regularity ofclinical pathogenesis, imaging features, treatment methods and treatment effects, andunderstand its early, medium-term follow-up results, provide advantaged conditions forclinical treatment strategies.Materials and methods:The materials and methods: collected51cases data of our hospital in January2010to January2015used Siemens64layer spiral CT aorta CTA or enhanced scan andconfirmed by surgery, male39cases, female12cases, age from6to86. Preoperativepresent with coughing up blood in10cases, chest pain in23cases, hoarse in2cases,17cases of hypertension, coronary heart disease in8cases, aortic atherosclerosis in27cases. There is a clear history of trauma in2cases. The aortic intramural hematoma in 18cases.Inspection equipment: Siemens64slice MDCT, intravenous injection of contrastmedium Omnipaque (300mg/ml) of100ml was used by high pressure injector with arate of4to5ml/s, start threshold is120HU, voltage is120KV, current is200-250mAs,thick is0.625to1.250mm. The pitch is1.375, the scanning time is5to7s, the patienthands up, hold breath when examination.The image after post-processing transferred toour hospital PACS system.Surgery material:13patients in our hospital undergo surgery with aneurysm repairintracavitary treatment, CTA is reviewed in postoperative3-6months.Results:The study found that in51patients with thoracic aorta pseudoaneurysms, male76%, female24%, most of the patients are aged between60to70years old. Most of thepatients clinical symptoms have no obvious specificity, most have asymptoms, thoracicaorta pseudoaneurysms is always found in imaging examination in other causes. Thereare a lot of PTAA causes, including trauma, complications after the operation,atherosclerosis, infections, autoimmune diseases (white’s disease), and arterial wallcongenital dysplasia, etc. The above all sorts of reasons cause the thoracic aorta wallrupture, blood comes into the surrounding tissue and result in localized hematoma, thena large amount of fibrous tissue wrapps, which lead to a PTAA. The common CT scanperformance of thoracic aorta pseudoaneurysms is low density or, density of soft tissuemass shadow near the main artery, cross section can be assumes the circular, round. Inearly period of enhancement scanning, tumors had more developed shallow light.Subsequently, tumors had an obvious reinforcement, then artery density decreases, andthe density of tumors had reduced faster than arteries.13patients in our hospitalundergo surgery with aneurysm repair intracavitary treatment, CTA is reviewed inpostoperative3-6months.Imageing display good condition of stent stick wall, noleakage, there is thrombus formation in the aneurysm cavity, tumors had smallerdiameter than previous.Conclusion:The aorta CTA is the most effective examination in the diagnosis of thoracic aortapseudoaneurysms, most of the patients are aged between60to70years old, mostlyolder men. Common location are the aortic arch and descending aorta. Endovascularaneurysm repairement is the main effective method for treatment of thoracic aorta pseudoaneurysms, deserving to be clinical promoted. Endovascular aneurysmrepairement is currently one of the effective methods of treatment of thoracic aortapseudoaneurysms, cure rate is high, the postoperative effect is good, should bepromoted.