| 李宇,刘家禕,张楠,张焕,范占明.应用主动脉CTA观察急性主动脉壁间血肿的演变[J].中国医学影像技术,2014,30(10):1490~1494 |
| 应用主动脉CTA观察急性主动脉壁间血肿的演变 |
| Prognosis of acute intramural hemotoma with whole aorta CTA |
| 投稿时间：2014-03-20 修订日期：2014-07-28 |
| DOI： |
| 中文关键词: 主动脉壁间血肿 随访研究 体层摄影术, X线计算机 |
| 英文关键词:Intramural hemotoma Follow-up studies Tomography, X-ray computed |
| 基金项目:北京市自然科学基金（7132086）。 |
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| 摘要点击次数: 2825 |
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| 中文摘要: |
| 目的 观察急性主动脉壁间血肿（IMH）的自然演变过程，探讨初发时的形态学特点及其与演变进展之间的关系。方法 收集221例急性IMH患者的临床资料及主动脉CTA形态学信息，对保守治疗的IMH患者初次发病后定期进行主动脉CTA检查。根据患者1年随访期间IMH的不同演变分为稳定组和进展组，比较两组临床资料及CTA征象的差异，分析影响IMH进展的相关因素。结果 135例IMH患者接受保守治疗，其中稳定组92例（Stanford A型7例），进展组43例（Stanford A型10例）；121例随访1年，14例半年后失访。IMH患者中73.76%（163/221）的患者既往有高血压病史。稳定组与进展组初发时血肿内局限性强化、血肿最大厚度、厚度／管腔直径、胸腔积液及心包积液检出率的差异均无统计学意义（P均>0.05），两组IMH类型、溃疡样变检出率差异有统计学意义（P均<0.05）。Logistic回归分析显示高血压、溃疡样变是影响IMH进展的危险因素。结论 IMH的类型、溃疡样变、高血压是IMH最主要的不良预后风险因子。 |
| 英文摘要: |
| Objective To observe the characteristics of acute intramural hematoma (IMH) and determine the predictive factors of evolution by CTA. Methods Totally 221 consecutive patients with IMH were enrolled. The clinical data and the morphological characteristics of initial CTA were recorded. The follow-up CTA of patients with conservative therapy were performed regularly, and then the patients were divided into stable group and progressive group according to the evolution in one year. The clinical data and CTA findings were compared. And the risk factors of evolution were analyzed. Results In 135 patients with conservative therapy after onset, 92 cases (7 cases with Stanford type A) were in stable group and 43 cases (10 cases with Stanford type A) were in progressive group. 14 patients were loss of follow-up in half a year. 73.76% (163/221) had the history of hypertension. The initial thickness of IMH, local enhancement, diameter of aorta, plural effusion and cardiac effusion had no difference between the two groups (all P>0.05), however the type of IMH, ulcer-like projection had significant difference (both P<0.05). The Logistic analysis showed the hypertension and ulcer-like projection were the progression risk factor of IMH. Conclusion The type of IMH, ulcer-like projection and hypertension are the risk factors of evolution. |
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