摘要
目的：探讨原发性肠系膜上动脉夹层（PDSMA）的CT表现。方法：回顾性分析资料完整的17例PDSMA患者的CT表现。10例行CTA，7例行全腹部CT平扫加双期增强扫描。由2位经验丰富的腹部专业医师单独阅片，分析病变部位及CT表现，并对瘤体的4个径线进行测量。结果：①17例增强扫描均见明显的真假双腔（17／17）。②15例显示内膜辫征（15／17）。③13例假腔内显示血栓征（13／17），其中2例假腔完全血栓化。④14例显示内膜破口（14／17）；7例显示假腔出口（7／17）。⑤9例显示肠管缺血征（9／17）。⑥瘤体近端距腹主动脉距离0．5～5．5cm，平均2．1cm。破口距腹主动脉距离1．6～5．6cm，平均2．6cm。瘤腔长度1．5～5．4cm，平均3．5cm。瘤腔宽度0．4～1．2cm，平均0．7cm。结论：CT能准确诊断PDSMA及相应肠管的血供情况，为临床治疗和追踪随访提供有力依据。
Objective： To explore the CT features of primary dissection of the superior mesenteric artery （PDSMA）. Methods：The CT features of 17 cases of PDSMA with complete data were retrospectively analyzed. Among them, 10 cases underwent CTA,and 7 cases underwent the plain scan, arterial phase, and venous phase of the whole abdomen. Imaging reading was performed independently by two experienced radiologists and four diameters of the PDSMA were measured. Results：Double-lumen sign was seen in all the cases,accounted for 100 % ; low-density intimal flap was seen in 15 cases,ac- counted for 93% ;mural thrombosis was seen in 13 cases,accounted for 76.50./00 ,and two cases false lumen were completely thrombosedldissection entry-site was seen in 14 cases,accounted for 82.3 %,and dissection re-entry site was seen in 7 ca- ses,accounted for 41.2%; bowel ischemia signs were seen in 9 cases,accounted for 52.9%;the distance of PDSMA proxi- mal to the orifice of the SMA ranged from 0.5-5.6cm （mean-2. 1cm）;the distance from entry-site to the orifice of the SMA ranged from 1.6 - 5.6cm （mean= 2.6cm） , the length of the false lumen ranged from 1.5 - 5.4cm （mean= 3.5cm） the width of the false lumen ranged from 0.4-1.2cm （mean-0.7cm）. Conclusion：CT can diagnose PDSMA and its corre- sponding intestinal blood supply accurately, providing powerful basis for clinical treatment and follow-up review.
出处
《放射学实践》
2014年第2期177-180,共4页
Radiologic Practice
关键词
肠系膜上动脉
夹层
体层摄影术
X线计算机
Mesenteric artery,superiorl Dissection
Tomography,X-ray computed
