主动脉夹层撕裂内膜走行规律在真假腔识别中的应用

目的:探讨主动脉夹层（AD）撕裂内膜走行规律在AD真假腔识别中的临床价值。方法:回顾性分析63例AD患者的MSCTA资料，在降主动脉不同节段轴位图像上测量夹层动脉撕裂内膜与管壁两个结合点的角度，计算真腔所处夹角角平分线（TLIAB）的角度以确定其所在象限，观测在血管不同节段、不同象限内TLIAB的数量。结果:63例夹层患者降主动脉不同节段所得TLIAB最多为126层，不同节段间TLIAB数量的差异有统计学意义（χ2=63.87，P<0.05）。相同节段、不同AD类型间TLIAB数量的差异无统计学意义。TLIAB在右前象限最多，以主动脉弓降部最明显，主动脉弓降部位于右前象限和左前象限的管腔88.89%为真腔。结论:根据主动脉夹层撕裂内膜走行规律识别真假腔是一种简便、快速、有效的方法。 

The Morphological Characteristics of Torn Vascular Intima Distinguishes True from False Lumen of Aortic Dissection

Objective: To use the morphological characteristics of torn vascular intima to distinguishes true from false lumen of aortic dissection (AD). Methods: Totally 63 MSCTA data of aortic dissection was enrolled into retrospective analysis. On axial images of different segments of the aorta, the intersection angle was measured between torn vascular intima of aortic dissection and both joint point on arterial wall, the angle of true lumen included angle bisector (TLIAB) was calculated, the TLIAB's quadrant was ascertained, the numbers of TLIAB in different segments and different quadrants was statistically compared by using student's χ2 test. Results: The maximum number of TLIAB was 126 in different segments of aorta in 63 patients. There were significant differences in the number of TLIAB between different segments (χ2 = 63.87, P < 0.05). There was no significant difference in the number of TLIAB between the same segments and different AD types. TLIAB was most common in the right anterior quadrant, most notably in the descending aortic arch; about 88.89％ of the lumen in the right anterior and left anterior quadrant was the true lumen. Conclusion: It is a useful, simple and fast method to distinguish the true lumen from false lumen of aortic dissection according to the morphological characteristics of torn vascular intima.