摘要
目的分析增强CT诊断孤立性肠系膜上动脉（SMA）夹层的价值。方法分析22例孤立性SMA夹层的CT特征，提出新的分型方法，并结合文献进行分析。结果22例夹层均累及SMA弯曲部前壁，其中21例（21／22，95．45％）经增强CT确诊；夹层近端距SMA开口平均（10．31±8．67）mm（0～32．03mm），夹层长度平均（73．37±42．69）mm（15．96-205．91mm）。按症状分组，无症状组（4例）夹层近端距SMA开口平均距离为（16．21±10．97）mm（1．00～32．03mm），有症状组（18例）平均为（9．17士6．15）mm（0～25．98mm）；无症状组夹层长度平均为（34．81±44．01）mm（15．96-73．84mm），有症状组平均为（83．46±41．90）mm（26．40-205．91mm）。无症状组真腔狭窄率平均为44．16％±12．33％，有症状组为74．35％±22．37％（P=0．042）。随着夹层向SMA远、近端延展，保守治疗效果变差。结论增强CT是诊断SMA夹层的有效方法。孤立性SMA夹层均累及SMA弯曲部前壁，临床症状及疗效与夹层长度和真腔狭窄度有关。本研究提出的新分型方法有助于全面描述SMA夹层的影像学特征，进而确定治疗方案。
Objective To analyze the value of contrast-enhanced CT（CECT） in diagnosis of isolated dissection of superior mesenteric artery （SMA）. Methods CT images of 22 patients with isolated dissection of SMA were retrospective evalua- ted. The relationship between CT features and symptoms and treatment effects was discussed. A new method for classifica- tion of dissection of SMA was proposed. Results Twenty one （21/22, 95.45%） patients were diagnosed using CECT. The dissections were aroundothe curved part of SMA in all the 22 patients. The mean distance from SMA ostium to the be- ginning of dissection was （10. 31 ± 8.67） mm （0--32.03 mm）. The mean length of dissection was （73.37 ± 42.69） mm （15.96--205.91 mm）. The mean distance from SMA ostium to the beginning of dissection was （16.21 ± 10. 97）mm （1.00--32.03 mm） in asymptomatic group （n=4） and （9.17±6.15）mm （0--25.98 mm） in symptomatic group （n=18）. The mean length of dissection was （34.81± 44.01） mm （15.96--73.84 mm） in asymptomatic group and （83.46 ± 41.90）mm（26.40--205.91 mm） in symptomatic group. The true lumen was more narrowed in symptomatic group （74.35% ± 22.37 % ） than in asymptomatic group （44.16 %± 12.33 %, P = 0. 042）. When dissection extended proximally or distally, the effect of conservative treatment went worse progressively. Conclusion CECT is valuable in diagnosis of i- solated dissection of SMA. The dissections are around the anterior wall of the curved part of SMA. The symptoms are re- lated with degree of stenosis of true lumen and the length of dissection. The newly proposed classification method is helpful for descripting imaging characteristics of SMA dissection and treatment planning.
出处
《中国介入影像与治疗学》
CSCD
2014年第8期515-519,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
肠系膜上动脉
夹层
诊断
预后
Superior mesenteric artery
Dissection
Diagnosis
Prognosis
