本文選題：腹主動脈瘤 + 瘤頸�。� 參考：《心肺血管病雜志》2016年09期

【摘要】：目的:探討CT血管成像(CTA)在復(fù)雜型腹主動脈瘤腔內(nèi)修復(fù)術(shù)前評估中的臨床應(yīng)用價值。方法:回顧性分析2014年1月至2015年12月間,于我中心經(jīng)腔內(nèi)修復(fù)的58例復(fù)雜型腹主動脈瘤患者,男性42例,年齡57~80歲,平均年齡(71.3±6.6)歲,術(shù)前CTA影像資料,對瘤頸的直徑變化、角度、長度進行分析測量,并與術(shù)中造影結(jié)果(DSA)比較。結(jié)果:(1)CT證實單因素復(fù)雜瘤頸7例,占12.1%,多因素復(fù)雜瘤頸51例,占87.9%,其中短瘤頸合并錐形瘤頸14例,占24.1%,錐形瘤頸合并瘤頸夾角60°的37例,占63.8%。(2)CTA與DSA測量值比較:瘤體最大直徑平均[(53.2±7.3)vs.(45±5.6)mm,t=4.022,P0.001;腎下腹主動脈直徑平均[(20.1±3.3)vs.(20.7±3.8)mm,t=0.793,P0.05],瘤體入口處腹主動脈直徑平均[(19.2±2.8)vs(18.7±3.1)mm,t=0.728,P0.05),差值平均[(1.9±0.8)vs.(0.9±0.5)mm,t=1.047,P0.05];瘤頸與瘤體成角平均[(49.3o±17.2o)vs.(36.4o±16.3o),t=5.416,P0.001;瘤頸長度平均[(27.7±5.1)vs.(25.7±6.5)mm,t=1.873,P0.05)。(3)手術(shù)成功率100%,術(shù)中造影發(fā)現(xiàn)即刻I型內(nèi)漏18例,占31.0%,17例經(jīng)球囊擴張內(nèi)漏消失,1例通過近端補CUFF內(nèi)漏消失;隨訪3個月支架穩(wěn)定,未見移位,無I型內(nèi)漏,各分支血管通暢。結(jié)論:腹主動脈瘤腔內(nèi)修復(fù)術(shù)前應(yīng)用CTA評估復(fù)雜瘤頸形態(tài),對手術(shù)成功有決定性意義。對于瘤體最大徑和瘤頸夾角應(yīng)參考CTA的測量結(jié)果,瘤頸長度及直徑變化與術(shù)中DSA無顯著性差異。
[Abstract]:Objective: to evaluate the clinical value of CT angiography (CTAA) in the preoperative evaluation of intraluminal repair of complex abdominal aortic aneurysms. Methods: from January 2014 to December 2015, 58 patients with complex abdominal aortic aneurysm (42 males, 5780 years old, mean age 71.3 鹵6.6) underwent endovascular repair in our center. The preoperative CTA imaging data and the diameter of the neck of the aneurysm were analyzed retrospectively. Angle and length were measured and compared with the results of intraoperative angiography. Results 7 cases (12.1%) of mono-factor complex tumor neck were confirmed by CT scan, 51 cases (87.9%) of multivariate complex tumor neck, including 14 cases of short neck with conical neck, accounting for 24.1 cases, and 37 cases of conical neck complicated with 60 擄angle of tumor neck. 鍗，

本文編號：1971249