| 许佳文,张艳,王晓华.主动脉壁内血肿合并分支动脉假性动脉瘤与合并溃疡样病变的比较[J].中国医学影像技术,2016,32(11):1673~1677 |
| 主动脉壁内血肿合并分支动脉假性动脉瘤与合并溃疡样病变的比较 |
| Comparison of aortic branch artery pseudoaneurysms associated with intramural hematoma and associated with ulcer-like projections |
| 投稿时间：2016-05-24 修订日期：2016-07-26 |
| DOI：10.13929/j.1003-3289.2016.11.013 |
| 中文关键词: 体层摄影术,X线计算机 随访研究 主动脉 血肿 动脉瘤,假性 溃疡样病变 |
| 英文关键词:Tomography, X-ray computed Follow-up studies Aorta Hematoma Aneurysm, false Ulcerlike projections |
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| 中文摘要: |
| 目的 探讨急性主动脉壁内血肿（IMH）合并分支动脉假性动脉瘤（BAPs）与合并溃疡样病变（ULP）的MSCT表现及其转归差异。方法 回顾性分析62例急性IMH的MSCT影像资料，观察测量IMH的分型、IMH范围内的主动脉最大外径、血肿最大厚度及是否合并BAPs/ULP，测量IMH合并BAPs/ULP的宽度、深度及长度，并对二者预后进行比较。结果 81个BAPs随访（21.6±12.5）个月，46个（46/81，56.79%）吸收，15个（15/81，18.52%）缩小，8个（8/81，9.88%）稳定，12个（12/81，14.81%）扩大。BAPs深度与其能否吸收显著相关（P<0.001），OR=2.824，OR的95%置信区间为（1.760，4.531）。34个ULP随访（24.8±18.0）个月，14个（14/34，41.18%）扩大，8个（8/34，23.53%）稳定，2个（2/34，5.88%）吸收，10个（10/34，29.41%）发生主动脉终点事件（3个形成主动脉夹层动脉瘤，7个形成动脉瘤）。IMH合并BAPs与IMH合并ULP的预后差异有统计学意义（χ2=55.559，P<0.001）。结论 急性期IMH常合并BAPs或ULP，MSCT可对二者进行鉴别，且能在随访中观察其动态演变，为临床治疗提供帮助。 |
| 英文摘要: |
| Objective To comparablely analyze the morphological characteristics and the prognosis of intramural hematoma (IMH) associated with aortic branch artery pseudoaneurysms (BAPs) and IMH associated with aortic branch ulcer-like projections (ULP) on MSCT. Methods MSCT imaging data of 62 patients with acute IMH were analyzed retrospectively. Stanford type, the maximum diameter of aorta, maximum thickness of hematoma, presence of BAPs and (or) ULP were observed. And the width, depth, length of BAPs and ULP were measured, the prognosis of IMH associated with BAPs was compared with ULP. Results During a mean follow-up of (21.6±12.5)months, in all of the 81 BAPs, 46 BAPs (46/81, 56.79%) disappeared; 15 (15/81, 18.52%) decreased in size; 8 (8/81, 9.88%) remained stable and 12 (12/81, 14.81%) increased in size. The depth of BAPs was associated with the prognosis of absorption (P<0.001), OR=2.824, 95%CI (1.760, 4.531). During a mean follow-up of (24.8±18.0) months in 34 ULP, 14 ULP (14/34, 41.18%) increased in size, 8 (8/34, 23.53%) remained stable, 2 (2/34, 5.88%) disappeared and 10 (10/34, 29.41%) led to the aortic events (including 3 aortic dissection and 7 aortic aneurysm). The prognosis of IMH associated with BAPs was significantly different with ULP (χ2=55.559, P<0.001). Conclusion BAPs and (or) ULP are common in acute IMH, MSCT can distinguish BAPs and ULP, and the dynamic evolution during follow-up can be observed to help clinical treatment. |
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