目的：探讨64层螺旋CT血管成像及后处理技术对孤立性肠系膜上动脉夹层（SISMAD）的诊断价值，及与数字减影血管造影对比分析。方法回顾分析17例使用64层螺旋CT及数字减影血管造影（DSA）所发现的孤立性肠系膜上动脉夹层，结合横断位原始图像及各后处理方法重建图像，分析其影像征像。结果64层螺旋CT血管成像动脉期能清晰显示肠系膜上动脉及其低密度的内膜片，真假腔及破裂口显示良好，夹层累及范围，是否存在血栓及累及分支血管，术后追踪观察方便、准确。结论多层螺旋CT能清晰显示孤立性肠系膜上动脉夹层的病变特征，其检出率、并发症显示优于DSA，并能较好地指导DSA介入治疗及预后观察，是孤立性肠系膜上动脉夹层首选的无创检查方法。%Objective To compare the diagnostic value between 64-slice CT and digital subtraction angiogra-phy (DSA) in isolated superior mesenteric artery (SISMAD) dissection. Methods Retrospective study was taken in 17 patients with SMA Dissection, evidenced by both 64-slice CT and DSA,analyze the eikonic signs according to trans-verse view and reconstruction images. Results In artetial phase, multislice CT could clearly showed superior mesen-teric artery, its hypodense intimal orifice, true and false double lumen and oral cleft, intercalated bed range involved, with or without thrombus and lateral branch blood vessels could be indicated well, which had great convenience to follow-up postoperative. Conclusion Multislice CT, an atraumatic mothod for SMA dissection, could clearly present its pathological changes. It also has better detection rate and less complication compared with DAS. Moreover, multi-slice CT could help to direct treatment by DSA.
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