大范围主动脉夹层动脉瘤患者的脉搏门控非增强快速MR成像特征及诊断敏感性-现代医学

大范围主动脉夹层动脉瘤患者的脉搏门控非增强快速MR成像特征及诊断敏感性

单位：鄂州市中心医院影像科, 湖北鄂州 436000

分类号：R543.1;R445.2

出版年·卷·期（页码）：2018·46·第三期（277-281）

摘要：

目的：分析脉搏门控非增强快速MR诊断大范围主动脉夹层动脉瘤的成像特征及诊断敏感性，以分析其临床诊断应用价值。方法：选取2015年7月至2017年7月间在本院诊治的大范围主动脉夹层动脉瘤患者41例作为研究对象，并以同期来院就诊的非夹层动脉瘤的肿瘤患者30例作为对照组。以CT血管造影检查（CTA）作为金标准，采用脉搏门控非增强快速MR成像检测分析MR成像特征及诊断敏感性。结果：大范围主动脉夹层动脉瘤的研究组患者采用MR检测后存在子囊、管腔密度不均、心包积液和胸腔积液的发生率均高于对照组，其中研究组患者存在管腔密度不均和胸腔积液的发生率与对照组相比较差异均具有统计学意义（P<0.05），大范围主动脉夹层动脉瘤MR成像显示管腔密度不均、主动脉管径增宽、假腔内存在血栓的发生率均较高（70.73%、78.05%、92.68%），累及左侧髂总动脉的发生率最高（68.29%），脉搏门控非增强快速MR诊断特异性和敏感性均为100%。结论：脉搏门控非增强快速MR诊断大范围主动脉夹层动脉瘤具有明显的成像特征及较高的诊断敏感性，可以在临床上推广应用。

Objective: To investigate the imaging characteristics and diagnostic sensitivity of large-scale aortic dissecting aneurysms with pulse-gated non-enhanced rapid MR in order to analyze its clinical value.Methods: 41 patients with a wide range of aortic dissecting aneurysms diagnosed and treated in our hospital from July 2015 to July 2017 were selected as research objects(research group). 30 patients with non-dissecting aneurysm who came to hospital in the same period were selected as control group. CT angiography (CTA) as the gold standard of all patients, pulse-gated non-enhanced rapid MR imaging was used, and MR imaging features and diagnostic sensitivity were analyzed. Results: The incident rates of ascus, uneven lumen density, pericardial effusion and pleural effusion in the research group were higher than those inthe control group. There werestatistically significant differences in the incident rates of lumen density and pleural effusion between the research group and the control group (P<0.05). MR imaging of a wide range of aortic dissecting aneurysms showed higher incidence of uneven lumen density, widened aortic diameter, and thrombi in the false lumen (70.73%, 78.05%, 92.68%), the incidence of the left common iliac artery involvement was the highest (68.29%), pulse-gated non-enhanced rapid MR diagnosticspecificity and sensitivity were 100%.Conclusion: Pulse-gated non-enhanced rapid MR diagnosis of aortic dissection in a wide range has obvious imaging features and high diagnostic sensitivity, it can be widely used in clinical practice.

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