目的 探讨320排CTA在主动脉夹层(AD)诊断中的价值.方法 回顾分析59例临床诊断AD患者的320排CTA检查资料,对比其与16排CTA、MRA及DSA的差异.结果 59例AD患者中,3种方法共诊断AD 43例,胸主动脉瘤4例,真性腹主动脉瘤9例,假性腹主动脉瘤3例.320排CTA诊断AD破口位置的准确率(75/77,97.40％)高于16排CTA(47/53,88.68％,x2=4.14,P＜0.05)及MRA(40/46,86.96％,x2=5.17,P＜0.05)；其电离辐射剂量[(849.62±44.73)mGy]低于16排CTA[(927.11±39.47)mGy,t=2.84,P＜0.05]及DSA[(976.85±54.21)mGy](t=2.51,P＜0.05),并可清晰显示内膜片、真假腔、血栓形成及主要内脏动脉分支受累情况.结论 320排CTA是诊断AD的安全、快捷、有效且无创的方法,对临床制定治疗方案有重要应用价值.%Objective To explore the value of 320-detector CT angiography (CTA) in diagnosis of aortic dissection (AD). Methods A total of 59 consecutive patients with suspected AD were enrolled. The results of 320-detector CTA with 16-detector CTA, MRA and DSA were compared. Results Totally 43 patients were diagnosed with 3 methods as AD, 4 with thoracic aorta aneurysm, 9 with abdominal aorta aneurysm and 3 with false abdominal aorta aneurysm. The diagnostic accuracy rate for preoperative revealing of the tears of 320-detector CTA {75/77, 97. 40%) was higher than that of 16-detector CTA (47/53, 88. 68%, χ2=4. 14, P<0. 05) and MRA (40/46, 86. 96%,χ2=5. 17, P<0. 05). The dose of radiation in examination of 320-detector CTA ([849. 62±44. 73]mGy) was lower than that of 16-detector CTA ([927. 11 + 39. 47]mGy, t=2. 84, P<0. 05) and DSA ([976. 85 + 54. 21]mGy, t=2. 51, P<0. 05). In addition, 320-detector CTA was able to display the intimal flap, the real and false lumen, the thrombus in false lumen and detail of significant branches of aorta. Conclusion 320-detector CTA is secure, quick, effective and noinvasive in diagnosing AD, thus has important clinical value in drawing up the treatment plan of AD.
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