胸主动脉搏动伪影与夹层的CT研究田帮明（安徽省霍山县医院237200）【中图分类号1R445.1文献标识码］A【文章编号11672-5085（2010）34-0048-03【摘要】目的分析CT平扫时正常胸主动脉及其搏动伪影和胸主动脉夹层的影像表现，提高诊断水平。材料和方法回顾分析63例正常胸主动脉CT平扫表现,回顾分析126例正常胸主动脉搏动伪影发牛率及其特点，回顾分析7例胸主动脉夹层（5例破裂）CT平扫表现。结果（1）63例正常胸主动脉在CT轴位像上均呈圆形及椭圆形（主动脉弓及其移行部），壁环宽窄相等，壁环密度与腔内血液相似32例，密度高于腔内血液31例。密度高低与平均年龄成正相关，与性别无关。（2）126例正常胸主动脉有81例在升主动脉边缘出现易与主动脉夹层混淆的半月形影，但此种半月形影只出现在升主动脉右后、左前、左后三个象限，而且与升主动脉环主体间常有一条线样低密度暗带而且总不会包括右前象限。（3）7例胸主动脉夹层均于主动脉环内见内膜片影（1例环内钙化斑、1例环内束状高密度、5例环内线状高密度影）；5例见升主动脉半月征，其中3例血栓之高密度半月影与内膜片影融合，，2例于升主动脉壁环见等密度半月影。但所有5例半月影均包括右前象限。结论胸主动脉环内出现连续多层可见、两端止于环壁、高密度线状或束状影是动脉内膜离开壁环的标志，紧贴主动脉环边缘的半月形、大半圆形等密度或高密度影是假腔血流未凝结或血栓形成的标志，这两个标志都是AD的确诊依据。而在升主动脉边缘出现的总不包括右前象限的与升主动脉主体间有线状暗带的半月影则是升主动脉搏动伪影。适当调高窗位、缩窄窗宽有利于AD检出。【关键词】胸主动脉夹层伪影CTTheaortathoracicalispulsatesthefalseshadeandthebandCTresearchHuoshanCountyhospitalBangmingTian[Abstract]Goal:AnalyzesCTsweepsevenlywhenthenormalaortathoracicalisandpulsatesthefalseshadeandtheaortathoracicalisbandphantomperformanee,raisesthediagnosislevel.Materialandmethod:Thereviewanalyzes63examplenormalaortathoracicalisCTtosweeptheperformaneeevenly,thereviewanalyzes126examplenormalaortathoracicalisestopulsatethefalseshadeformationrateandthecharacteristic,thereviewanalyzes7exampleaortathoracicalisband(5examplestoburst)CTtosweeptheperformaneeevenly.Finally:1st,63examplenormalaortathoracicalisesassumethecircularandtheellipseontheCTaxispositionelephant(archoftheaortaanddivideandhyphenateawordattheendofaline),themuralcirclewidthisequal,inthemuralcircledensityandthecavitythebloodsimilar32examples,thedensityishigherthaninthecavitytheblood31examples.Thedensityheightandtheaverageagebecomearebeingconnected,hasnothingtodowithwiththesex・2nd,126examplenormalaortathoracicaliseshave81examplestoappearintheascendingaortaedgeeasilywiththeaortabandconfusionmeniscusshade,butthiskindofmeniscusshadeonlyappearsaftertheascendingaortaright,leftfront,theleftlatterthreequadrants,moreoverthecommonlinetypelowdensityblankingbarmoreoveralwayscannotineludetherightfrontquadrantwiththeascendingaortalinkmainbodybetween.In3rd,7exampleaortathoracicalisbandseesthediaphragmshadeintheaortalink(in1examplelinkcalc讦icationspot,in1examplelinkinternalbeamshapehighdensity,5examplelinksstriationhighdensityshade);5examplesseetheascendingaortahalfamonthtodraft,highdensityofhalfamonthshade3examplethrombuswithindiaphragmshadefusion,2examplesseestheequilibriumdensityhalfamonthshadeintheascendingaortamuralcircle.Butall5examplehalfamonthshadeincludingrightinfrontofquadrant.Conclusion:Intheaortathoracicalislinkappearsthecontinualmulti-layer,thebothsidesstopsYuHuanbi,thehighdensitystriationortiestheshapeshadeisobviouslytheaortathoracicalisinternalmembraneleavesthemuralcirclethesymbol,clingstheaortalinkedgethemen...