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目的探讨主动脉夹层(AD)早期诊断的 ,以提高AD的早期确诊率。方法分析总结2004年至2009年张掖市人民医院62例AD患者的临床资料。62例均行超声心动图检查;26例行普通CTA检查,其中16例行64层螺旋CTA检查;18例行磁共振(MRI)检查;2例行主动脉腔内造影。结果 UGG检查62例,检出Ⅰ型29例,Ⅱ型14例,Ⅲ型15例,诊断符合率为93.55%。CTA检查26例:Ⅰ型16例,Ⅱ型6例,Ⅲ型4例;行磁共振(MRI)检查18例:Ⅰ型10例,Ⅱ型3例,Ⅲ型5例;64层螺旋CTA16例:Ⅰ型5例,Ⅱ型3例,Ⅲ型8例;主动脉腔内造影2例,均为Ⅱ型。结论彩色多普勒对AD诊断可靠,诊断符合率高,对AD的早期诊断尤为重要;CTA、64层螺旋CTA、MRI、主动脉腔内造影均能对AD起确诊作用。
Objective To explore the early diagnosis of aortic dissection (AD) in order to improve the early diagnosis of AD. Methods The clinical data of 62 AD patients from 2004 to 2009 in Zhangye People’s Hospital were summarized and analyzed. Sixty-two patients underwent echocardiography. Twenty-six patients underwent routine CTA examination. Sixteen patients underwent 64-slice spiral CT angiography (CTA), 18 underwent magnetic resonance imaging (MRI) and two underwent aortic endovascular imaging. Results In UGG examination, 62 cases were detected, 29 cases were type Ⅰ, 14 cases were type Ⅱ and 15 cases were type Ⅲ. The diagnostic coincidence rate was 93.55%. CTA examination of 26 cases: type Ⅰ in 16 cases, type Ⅱ in 6 cases, type Ⅲ in 4 cases; magnetic resonance imaging (MRI) in 18 cases: type Ⅰ in 10 cases, type Ⅱ in 3 cases, type Ⅲ in 5 cases; 64-slice CTA16 cases : Type Ⅰ in 5 cases, type Ⅱ in 3 cases, type Ⅲ in 8 cases; aortic endovascular imaging in 2 cases, are type Ⅱ. Conclusions Color Doppler ultrasound is reliable for diagnosis of AD and high coincidence rate of diagnosis. It is particularly important for the early diagnosis of AD. CTA, 64-slice CTA, MRI and aortic endarterectomy can all confirm the diagnosis of AD.