超微血流成像技术评估腹主动脉夹层患者分支动脉受累的临床价值

摘要

目的 探讨超声超微血流成像技术(SM I)对Stanford B型主动脉夹层(AD)患者腹主动脉分支动脉受累的临床诊断价值.方法 对34例AD患者腹主动脉及其分支动脉(腹腔动脉、肠系膜上动脉、双侧肾动脉)进行常规超声以及SMI检查,同时行计算机断层扫描血管造影(CTA)检查,分析分支动脉受累的声像图特点,比较常规超声、 SMI与CT A诊断分支动脉受累的一致性.结果 34例AD患者136条分支动脉中,根据分支动脉受累超声表现分为真腔供血组(81支) 、动脉夹层组(27支) 、假腔供血组(16支)和动脉骑跨组(12支) .常规超声和SMI诊断AD患者分支动脉受累与CT A诊断符合率分别为76 .5% (104／136)和92 .6% (126／136) ,差异具有统计学意义( P ＜0 .001) .结论SM I可直接评价腹主动脉分支动脉受累情况,在AD患者术前评估和术后随访中具有重要意义.%To investigate the clinical diagnostic value of ultrasonographic superb micro‐vascular imaging ( SM I) for abdominal branch arteries′involvement in Stanford B aortic dissection ( AD ) . Methods A total of 34 AD patients underwent conventional ultrasound ,SMI and CTA . The characteristics of the ultrasonographic images of branch artery involvement including coeliac artery ,superior mesenteric artery ,left and right renal artery were analyzed . T he diagnostic performance of conventional ultrasound and SM I were compared and CT A was used as the reference standard . Results Among the 34 patients with AD ,according to the ultrasonographic images′characteristics ,136 branch arteries were categorized into four classes :Class Ⅰ (81/136) ,branch artery perfusion supplied from the aortic true lumen ; Class Ⅱ ( 27/136) , dissection extending into the branch ; Class Ⅲ ( 16/136 ) ,branch artery perfusion supplied from the aortic false lumen ; Class Ⅳ ( 12/136) ,branch artery perfusion supplied from the aortic true and false lumens . T he diagnostic accordance rate of the conventional ultrasound and SM I were 76 .5% ( 104/136 ) and 92 .6%( 126/136) and had significant differences ( P ＜0 .001) . Conclusions SMI can be used to evaluate branch artery involvement in AD patients w hich will guide the practice of pre‐operation and post‐operation .