64排CTA与超声心动图在诊断主动脉夹层中的应用
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摘要
目的探讨64排CT血管成像(CTA)与超声心电动图在主动脉夹层的应用及诊断价值。方法选择2015年3月-2018年3月在我院确诊为主动脉夹层患者57例进行回顾性分析,所有患者均使用64排CTA、超声心动图检查,观察两种诊断方式诊断异常结果(总体异常、主动脉弓部异常、主动脉瓣膜异常、胸及腹主动脉异常、冠状动脉异常)、DeBakey分型(Ⅰ型、Ⅱ型、Ⅲ型)及Stanford分型(A型、B型)的诊断情况。结果 64排CTA、超声心电动图对总体异常、主动脉瓣膜异常检出率,差异无统计学意义(P>0.05);超声心电动图对主动脉弓部异常检出率高于64排CTA(P<0.05),64排CTA冠状对动脉异常、胸及腹主动脉异常检出率高于超声心电动图(P<0.05)。64排CTA、超声心电动图对DeBakeyⅠ型、DeBakeyⅡ型、Stanford A型检出率,差异无统计学意义(P>0.05);64排CTA冠状对DeBakeyⅢ型、Stanford B型检出率高于超声心电动图(P<0.05)。结论两种诊断方式的临床诊断均存在各自缺陷,但64排CTA与超声心动图比较诊断优势明显,临床使用价值相对较高。
Objective To explore the application and diagnostic value of 64-slice CT angiography(CTA) and ultrasonic cardiogram in the diagnosis of aortic dissection. Methods A total of 57 cases of aortic dissection diagnosed in our hospital from March 2015 to March 2018 were analyzed retrospectively. All patients were given 64-slice CTA and ultrasonic cardiogram to observe the abnormal diagnostic results of the two diagnostic methods(overall abnormalities, aortic arch abnormalities, aortic valve abnormalities, thoracic and abdominal aortic abnormalities, coronary artery abnormalities), DeBakey classification(type I, type II, type III) and Stanford classification(type A, type B). ResultsThere were no significant differences in the overall abnormalities and aortic valve abnormalities between 64-slice CTA and ultrasonic cardiogram(P>0.05). The detection rate of abnormal aortic arch of ultrasonic cardiogram was higher than that of 64-slice CTA(P<0.05), and the detection rates of coronary artery abnormalities, thoracic and abdominal aortic abnormalities of 64-slice CTA were higher than those of ultrasonic cardiogram(P<0.05). There were no significant differences in the detection rates of DeBakey type I, DeBakey type II and Stanford type A between 64-slice CTA and ultrasonic cardiogram(P>0.05). The detection rates of DeBakey type III and Stanford type B of 64-slice CTA were higher than those of ultrasonic cardiogram(P<0.05). Conclusion There are certain defects in the clinical diagnosis of the two diagnostic methods, but the 64-slice CTA has obvious advantages than ultrasonic cardiogram, and it has relatively high clinical application value.
Objective To explore the application and diagnostic value of 64-slice CT angiography(CTA) and ultrasonic cardiogram in the diagnosis of aortic dissection. Methods A total of 57 cases of aortic dissection diagnosed in our hospital from March 2015 to March 2018 were analyzed retrospectively. All patients were given 64-slice CTA and ultrasonic cardiogram to observe the abnormal diagnostic results of the two diagnostic methods(overall abnormalities, aortic arch abnormalities, aortic valve abnormalities, thoracic and abdominal aortic abnormalities, coronary artery abnormalities), DeBakey classification(type I, type II, type III) and Stanford classification(type A, type B). ResultsThere were no significant differences in the overall abnormalities and aortic valve abnormalities between 64-slice CTA and ultrasonic cardiogram(P>0.05). The detection rate of abnormal aortic arch of ultrasonic cardiogram was higher than that of 64-slice CTA(P<0.05), and the detection rates of coronary artery abnormalities, thoracic and abdominal aortic abnormalities of 64-slice CTA were higher than those of ultrasonic cardiogram(P<0.05). There were no significant differences in the detection rates of DeBakey type I, DeBakey type II and Stanford type A between 64-slice CTA and ultrasonic cardiogram(P>0.05). The detection rates of DeBakey type III and Stanford type B of 64-slice CTA were higher than those of ultrasonic cardiogram(P<0.05). Conclusion There are certain defects in the clinical diagnosis of the two diagnostic methods, but the 64-slice CTA has obvious advantages than ultrasonic cardiogram, and it has relatively high clinical application value.
引文
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[9]罗艳红,吴昊,祝明华,等.急诊主动脉夹层超声心动图和多层螺旋C T诊断对比分析[J].中国超声医学杂志,2015,31(2):123-125.
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[11]肖子亚,王豪俊,姚晨玲,等.主动脉夹层患者多层螺旋CT血管成像表现及其与院内死亡的关系[J].中华心血管病杂志,2017,45(3):217-222.
[12]董辉,张会芳,李兆洋,等.急诊床旁经胸超声心动图联合多层螺旋CT在主动脉夹层诊断中的应用价值[J].海南医学,2017,27(8):1285-1287.
[13]Bilku R S,Steadman C D,Jordan P J.Acute DeBakey TypeⅢ(or Stanford Type B)aortic dissection diagnosed by transthoracic echocardiography.[J].Journal of the American Society of Ec hocardiography,2008,21(9):1080.e 1-1080.e3.
[14]车友谊,许江兵,邓文明,等.CT三维重建对DeBakeyⅠ-Ⅲ型主动脉夹层的诊断价值分析[J].中国CT和MRI杂志,2016,14(7):47-48.
[15]邱景伟,王翠珍,浦奎.主动脉夹层行主动脉CTA后肾功能异常:对比剂致急性肾损伤还是夹层扩展[J].中国循证心血管医学杂志,2017, 9(7):866-867.
[2]Gennari M,Annoni A,Agrifoglio M.Undiagnosed Stanford type A aortic dissection:a rare survival report[J]. International Journal of Cardiovascular Imaging,2016,32(4):659-660.
[3]宋光民.主动脉夹层的临床分型进展[J].山东医药,2009,49(18):111-112.
[4]Osmundson P J.Acute aortic dissection[J].Postgraduate Medicine,2017,49(5):132-137.
[5]佘红胜,吉六舟,沈又利,等.MSCT诊断不典型主动脉夹层的临床应用研究[J].CT理论与应用研究,2017,26(2):231-239.
[6]曹钰,李东泽.急性主动脉夹层的早期诊断和评估[J].西部医学,2017,29(12):1633-1636.
[7]王堂娟,吕洋,陈娟,等.超声心动图与CTA对主动脉夹层诊断价值的分析[J].中国CT和MRI杂志,2016,14(12):55-57.
[8]翁文超,黄继.超声心动图对急性胸痛病因鉴别诊断的临床价值分析[J].医学影像学杂志,2017,27(9):1823-1825.
[9]罗艳红,吴昊,祝明华,等.急诊主动脉夹层超声心动图和多层螺旋C T诊断对比分析[J].中国超声医学杂志,2015,31(2):123-125.
[10]张贺诚,鲁春磊,刘悦,等.多排螺旋CT在主动脉夹层诊断中的应用价值[J].中国CT和MRI杂志,2016,14(11):40-42.
[11]肖子亚,王豪俊,姚晨玲,等.主动脉夹层患者多层螺旋CT血管成像表现及其与院内死亡的关系[J].中华心血管病杂志,2017,45(3):217-222.
[12]董辉,张会芳,李兆洋,等.急诊床旁经胸超声心动图联合多层螺旋CT在主动脉夹层诊断中的应用价值[J].海南医学,2017,27(8):1285-1287.
[13]Bilku R S,Steadman C D,Jordan P J.Acute DeBakey TypeⅢ(or Stanford Type B)aortic dissection diagnosed by transthoracic echocardiography.[J].Journal of the American Society of Ec hocardiography,2008,21(9):1080.e 1-1080.e3.
[14]车友谊,许江兵,邓文明,等.CT三维重建对DeBakeyⅠ-Ⅲ型主动脉夹层的诊断价值分析[J].中国CT和MRI杂志,2016,14(7):47-48.
[15]邱景伟,王翠珍,浦奎.主动脉夹层行主动脉CTA后肾功能异常:对比剂致急性肾损伤还是夹层扩展[J].中国循证心血管医学杂志,2017, 9(7):866-867.