本文選題：體層攝影術(shù)　切入點(diǎn)：X線計(jì)算機(jī)　出處：《中國(guó)醫(yī)學(xué)影像技術(shù)》2017年01期

【摘要】：目的觀察Stanford A型和Stanford B型主動(dòng)脈夾層(AD)主動(dòng)脈腔內(nèi)的撕裂內(nèi)膜走行規(guī)律。方法回顧性分析65例AD患者的CTA資料,在胸腰椎體和椎間隙層面軸位圖像上確定夾層動(dòng)脈撕裂內(nèi)膜與管壁兩個(gè)結(jié)合點(diǎn)的位置,并計(jì)算真腔所處夾角角平分線(TLIAB)的鐘點(diǎn)數(shù)。同時(shí)觀察AD對(duì)主動(dòng)脈分支大血管的影響情況。結(jié)果升主動(dòng)脈段Stanford A型內(nèi)膜撕裂由主動(dòng)脈根部向弓部呈順時(shí)針旋轉(zhuǎn);真腔位于主動(dòng)脈腔左側(cè)約3~6點(diǎn)位置,TLIAB位置的平均鐘點(diǎn)數(shù)為4.16±1.51。降主動(dòng)脈段AD內(nèi)膜撕裂由近端向遠(yuǎn)端呈逆時(shí)針旋轉(zhuǎn),Stanford A型和B型撕裂模式大致相同,旋轉(zhuǎn)幅度相似;主動(dòng)脈弓降部真腔位于主動(dòng)脈腔右側(cè),TLIAB位于8~9點(diǎn),降主動(dòng)脈遠(yuǎn)端TLIAB位于7~8點(diǎn)。左冠狀動(dòng)脈均開口于真腔,其鐘點(diǎn)數(shù)(3.82±0.41)與對(duì)應(yīng)層面TLIAB(3.69±0.82)差異無統(tǒng)計(jì)學(xué)意義(t=0.86,P=0.40);右冠狀動(dòng)脈開口緊鄰血管壁內(nèi)膜撕裂處。Stanford A型和B型AD的降主動(dòng)脈段分支血管起源部位分型差異均無統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論AD內(nèi)膜呈螺旋狀撕裂,升主動(dòng)脈段由主動(dòng)脈根部至弓部呈順時(shí)針旋轉(zhuǎn),降主動(dòng)脈段由弓降部至遠(yuǎn)端呈逆時(shí)針旋轉(zhuǎn)且Stanford A、B型的旋轉(zhuǎn)模式大致相同。Stanford A型和B型AD主動(dòng)脈分支大血管的受累情況相似。
[Abstract]:Objective to observe the pattern of intra aortic laceration in Stanford A and Stanford B aortic dissection.Methods the CTA data of 65 patients with AD were analyzed retrospectively. The location of the two junction points between the intima and the wall of the dissecting artery was determined on the axial images of thoracolumbar vertebral body and intervertebral space, and the clock points of the angle of the true cavity were calculated.At the same time, the influence of AD on aorta branches was observed.Results the Stanford A intimal tear of ascending aortic segment was rotated clockwise from the root of the aorta to the arch, and the average number of hours of the true cavity was 4.16 鹵1.51 in the left side of the aortic cavity at about 3 ~ 6 o'clock in the position of TLIAB.The AD intimal tear of descending aortic segment was rotated counterclockwise from proximal to distal end, and the pattern of A and B tears was similar, and the true cavity of descending part of aortic arch was located at TLIAB at 89 points on the right side of aortic cavity.The distal TLIAB of descending aorta was located at 8 o'clock.The left coronary artery was open in the true cavity.There was no significant difference in the number of hours (3.82 鹵0.41) and the corresponding level (TLIAB(3.69 鹵0.82). There was no significant difference in the origin of descending aorta branches between the right coronary artery openings adjacent to the intimal tear of the wall. There was no significant difference in the origin of the descending aorta branches between the right coronary artery openings and the type A and B AD.Conclusion the intima of AD is spirally torn and the ascending aortic segment rotates clockwise from the root of the aorta to the arch.The descending aortic segment rotated counterclockwise from the descending part of the arch to the distal end, and the pattern of Stanford A type B rotation was similar to that of Stanford A type A and B type AD aortic branches.
【作者單位】： 包頭市第八醫(yī)院醫(yī)學(xué)影像科;內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院影像診斷科;
【基金】：內(nèi)蒙古自治區(qū)衛(wèi)生和計(jì)劃生育委員會(huì)科研項(xiàng)目(201301050)
【分類號(hào)】：R543.1;R816.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前3條

1 段麗春;李曉光;朱莉;;主動(dòng)脈夾層撕裂并發(fā)急性腎衰竭患者1例的治療與護(hù)理[J];吉林醫(yī)學(xué);2011年13期

2 李榮,周淑英,楊麗娟;主動(dòng)脈夾層撕裂合并急性心肌梗死的觀察與護(hù)理[J];當(dāng)代護(hù)士(學(xué)術(shù)版);2005年03期

3 ;[J];;年期

，

本文編號(hào)：1720132