電腦斷層攝影對主動脈剝離的診斷

Computed Tomography in Evaluating Aortic Dissection

馬永基(Weng K. Ma) ； 謝明仁(Ming J. Hsieh) ； 刁翠美(Chui M. Tiu) ； 楊建芳(Chien F. Yang) ； 張遵(T. Chang)

《中華放射線醫學雜誌》 11卷1期 (1986/03) Pp. 29-36

摘要

有十八例病人因急性胸痛且顯示不正常的胸部X光表徵，臨床懷疑為主動脈剝離症，經電腦斷層攝影檢查，8例病患判讀有主動脈剝離，其中3例經開刀手術證實，有6例並施以主動脈血管攝影。4例認定患此疾病，而2例為主動脈瘤併有粥樣化；其餘患者未手術僅內科治療。
CT診斷主動脈剝離有三項主要指標：1)雙管腔、2)內膜瓣、3)內膜鈣化的移位。CT診斷主動脈剝離症的8例病人，有二例急性主動脈瘤破裂，於CT影像表現有心包積血，後經外科手術治療並證實此疾。這兩例病人不幸皆在手術中或手術後不治死亡。
CT除了能安全迅速診斷主動脈剝離症外，且能準確指出病變的位置、擴展情形、分類及其合併症，並且對病程的進行及預後都可提供可靠的資料。

並列摘要

Eighteen cases having acute onset of chest pain with abnormal chest radiograph, were evaluated by CT examination. There were ten patients diagnosed with aortic dissection on CT, but two of them were aortic aneurysm with atheroma disclosed by aortography.
A couple of cases with aortic dissection were shown CT appearance of hemopericardium and pleural effusion which had proven on surgery, and patients expired during or just after operation.
Aortography had been performed in six cases, aortic dissection was diagnosed in four out of six.
The criteria for diagnosis of aortic dissection by CT scan include: 1) double channels. 2) intimal flap, and 3) displaced intimal calcification.
CT can accurately diagnose the aortic dissection. Furthermore, it is a non-invasive & safe method, can detect the location and extent, classification and complication, the prognosis and the progresssion of the disease.