Keywords:
Cardiovascular system, Cardiac, Vascular, CT-Angiography, CT, MR-Functional imaging, Diagnostic procedure, Surgery
Authors:
A. Zhi, R. Dai, P. Zhang, S. Jiang, B. Lv; Beijing/CN
DOI:
10.26044/ecr2019/C-2883
Aims and objectives
The aortic root and central pulmonary artery (main pulmonary artery,
left/right pulmonary artery trunk) have an anatomical common adventitial[1-3],
connective tissue sheath structure[2,
4],
especially in the posterior wall of the aortic root[2].
In type A aortic dissection or intramural hematoma,
the aortic wall ruptures to the adventitia.
Increased intramural pressure causes extravasation,
or breaks into the common adventitia and continues to the main pulmonary artery and the left and right pulmonary artery,
resulting in pulmonary artery hematoma.
When the hematoma is large,
it may even cause stenosis of the pulmonary artery,
and the rupture of the medial layer of the pulmonary artery can cause pulmonary artery dissection.
Guilmette et al[5] retrospectively analyzed the pathological anatomy and histological manifestations of 3 AD and HPS patients by autopsy and pathology,
confirming the above mechanism of HPS.
There are relatively few articles reported about aortic dissection or intramural hematoma involving pulmonary arteries.
In 2009,
Sueyoshi et al[6] retrospectively analyzed the CT findings of 232 patients with Stanford type A acute AD,
and 21 patients of them were HPS,
the detection rate was 9.1%.
This is the largest group of literature so far.
The 20 patients reported by Guilmette et al[5] in 2016 are the second largest group of literature.
Currently there are few reports in this field and lack of literature on prognosis.
We retrospectively diagnosed 264 such patients and analyzed the short-term prognosis during hospitalization.
To investigate the diagnostic and clinical features of CT in type A aortic dissection or intramural hematoma involving pulmonary artery,
in order to improve clinical diagnosis,
treatment and prognosis.