MSCT重建联合CT血管造影在胸腹主动脉夹层诊断中的价值分析OA

Objective To analyze the value of multi-slice spiral CT(MSCT)reconstruction combined with CT angiography(CTA)in the diagnosis of thoracoabdominal aortic dissection.Methods A total of 117 patients with suspected thoracoabdominal aortic dissection admitted to the hospital from.All patients underwent MSCT plain scan and CTA enhanced scan after admission.The original data of MSCT plain scan were post-processed and reconstructed by multi-planar reconstruction(MPR),maximum intensity projection(MIP),volume rendering(VR),etc.Then,taking digital subtraction angiography(DSA)or surgical pathological results as the gold standard,the diagnostic efficacy of MSCT plain scan,MSCT reconstruction,CTA alone and in combination for thoracoabdominal aortic dissection was compared and analyzed.At the same time,the evaluation results of the four diagnostic methods for the typing of thoracoabdominal aortic dissection,the intimal tear and the involvement of branch vessels were evaluated.Results ①When MSCT plain scan,MSCT reconstruction and CTA were used in combination for the diagnosis of thoracoabdominal aortic dissection,the diagnostic efficacy was higher than that of single diagnosis.The diagnostic efficacy of MSCT reconstruction was better than that of MSCT plain scan,and the difference was statistically significant(P<0.05).There was no significant difference in the diagnostic efficacy between CTA and MSCT reconstruction(P>0.05).The consistency between the combined diagnosis and the gold standard was good(Kappa=0.928),the consistency between CTA,MSCT reconstruction and the gold standard was moderate(Kappa=0.706,0.689),and the consistency between MSCT plain scan and the gold standard was poor(Kappa=0.453).②When MSCT plain scan,MSCT reconstruction and CTA were used in combination,the evaluation coincidence rates for Stanford type A and Stanford type B of thoracoabdominal aortic dissection were respectively,which were higher than those of MSCT plain scan,MSCT reconstruction and CTA in single diagnosis,and the differences were statistically significant(P<0.05).③The results of the gold standard showed that there were a total of 108 intimal tears.When MSCT plain scan,MSCT reconstruction and CTA were used in combination for evaluation,the detection rate of intimal tears in thoracoabdominal aortic dissection was 95.37%,which was higher than that of MSCT plain scan(62.96%),MSCT reconstruction(77.78%)and CTA(82.41%)in single evaluation,and the differences were statistically significant(P<0.05).④The results of the gold standard showed that a total of 60 patients had involvement of branch vessels.When MSCT plain scan,MSCT reconstruction and CTA were used in combination for evaluation,the detection rate of involvement of branch vessels in patients with thoracoabdominal aortic dissection was 95.37%,which was higher than that of MSCT plain scan(62.96%),MSCT reconstruction(77.78%)and CTA(82.41%)in single evaluation,and the differences were statistically significant(P<0.50).Conclusion MSCT reconstruction combined with CTA has high diagnostic efficacy for thoracoabdominal aortic dissection,which can provide reliable imaging support for clinical diagnosis and treatment and is worthy of popularization.