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目的:探讨多层螺旋CT血管造影在主动脉夹层临床诊断中的应用价值。方法:回顾性分析舟山市普陀区人民医院和舟山医院2015年1月至2019年12月收治并经数字减影血管造影检查确诊为主动脉夹层患者78例的临床资料，均采用多层螺旋CT血管造影和数字减影血管造影检查，比较两种检查方法对主动脉夹层各种分型、主动脉破口数、破口处距左锁骨下动脉距离、累及分支血管、动脉壁钙化率及动脉夹层血栓等检出情况。结果:78例患者经数字减影血管造影检查均确诊为主动脉夹层，多层螺旋CT血管造影检出75例（96.2%），分型与数字减影血管造影相同，有3例误诊为心包炎。两种方法在检查主动脉破口数、破口处距左锁骨下动脉距离等差异均无统计学意义（n t=1.02、0.57，均n P>0.05），而多层螺旋CT血管造影累及分支血管61.3%（46/78）、动脉壁钙化率26.7%（20/78）、动脉夹层血栓检出率78.7%（59/78），均高于数字减影血管造影的43.6%（34/75）、12.8%（10/75）、62.8%（49/75），两组差异均有统计学意义（χn 2=4.83、4.65、4.62，均n P 0.05). The involved branches [61.3% (46/78),] the percentage of artery wall calcification [26.7% (20/78)], and the percentage of arterial dissection thrombosis [78.7% (59/78)] determined by multi-slice spiral CT angiography were significantly higher than 43.6% (34/75), 12.8% (10/75), and 62.8% (49/75) respectively determined by digital subtraction angiography ( n χ2 = 4.83, 4.65, 4.62, all n P < 0.05).n Conclusion:Multi-slice spiral CT angiography exhibits a similar capacity to identify aortic dissection to digital subtraction angiography. It can accurately determine the number and location of aortic lacunas, display the calcification and thrombosis of vascular wall, and is minimally invasive and simply operated. Therefore, multi-slice spiral CT angiography is of high application value in the clinical diagnosis and preoperative evaluation of aortic dissection.