没有血瘤的内脏撕裂:大动脉剖析的一个重要变体,可以逃避当前的成像技术
L G Svensson1, S B Labib, A C Eisenhauer
1Center for Aortic Surgery and Marfan Syndrome Clinic, Divisions of Cardiovascular Surgery and Cardiovascular Medicine, Lahey Hitchcock Clinic, Burlington, MA, USA.
Circulation
|March 17, 1999
概括
先进的成像可以错过微妙的大动脉剖析. 对于疑似患有上升性大动脉动脉瘤和门吐的病例,建议进行进一步的动脉造影,从而成功进行手术修复.
科学领域:
- 心血管外科心血管外科
- 诊断成像 诊断成像 诊断成像
- 胸前大动脉疾病 胸前大动脉疾病
背景情况:
- 现代成像 (食管横断心声学,CT,MRI) 对经典的大动脉剖析具有很高的灵敏度.
- 事报告表明,细微的大动脉剖析变体的错误诊断导致死亡率.
研究的目的:
- 为了调查微妙的大动脉解剖的错误诊断,尽管有先进的成像.
- 为了确定图像和临床特征与错过微妙的大动脉剖析相关.
主要方法:
- 181名接受上升或大动脉门修复的患者的回顾性审查.
- 对未经主动脉解剖的患者进行的手术前成像研究的详细分析.
主要成果:
- 9名患者 (5%) 在手术前错过了微妙的大动脉剖析.
- 所有错过的病例都经历了多种成像技术,并显示了上升的大动脉扩张和/或大动脉回.
- 亲密的眼是有限的,没有广泛的破坏或亲密的片.
结论:
- 先进的成像可能会错过微妙的大动脉剖析.
- 在未通过非侵入性成像证实的疑似病例中,建议使用多视图的动脉造影.
- 带有异常突起的上升动脉瘤和大动脉吐需要紧急进行手术.
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