CT characteristics and treatment options of spontaneous isolated dissection of celiac artery:a single-center experience
10.3969/j.issn.1002-1671.2023.12.011
- VernacularTitle:自发性孤立性腹腔干动脉夹层的CT特征及治疗策略选择
- Author:
Di ZHANG
1
;
Mingxu JIN
;
Xinying WU
;
Haobo SU
;
Jianping GU
;
Xindao YIN
;
Liping WANG
Author Information
1. 南京医科大学附属南京医院影像科,江苏 南京 210006
- Keywords:
computed tomography;
spontaneous isolated dissection;
celiac artery;
treatment
- From:
Journal of Practical Radiology
2023;39(12):1957-1961
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the demographic data,CT characteristics,treatment methods and follow-up results of patients with spontaneous isolated dissection of celiac artery(SIDCA)and to explore the selection of treatment strategy for SIDCA.Methods Medical records of 31 patients diagnosed as SIDCA were selected.The patients were divided into 2 groups,symptomatic group and asymptotic group.Demographic data,morbidity season,CT characteristics(type,distance of the entry site from the origin of the artery,dissection length,compression rate of the true lumen,branches involvement,organ ischemia,coexisting vasculopathy),treatment methods,and follow-up results were analyzed.Results Thirty-one patients were identified by CT contrast scan,22 were symptomatic and 9 were asymptomatic.22 patients were first diagnosed in cooler season,compared with 9 patients in warmer season(22 vs 9,Fisher's exact test,P=0.029).The difference between symptomatic and asymptomatic groups about branches involvement in patients was significant(8/14 vs 0/9,Fisher's exact test,P=0.007).Treatment included observation in 24,endovascular intervention in 6 patients and surgical repair in 1 patient.No patient required bowel resection.The mean follow-up period was 13.75 months.Except for 2 patients,the condition of the remaining patients improved or stabilized during follow-up.Conclusion The difference between symptomatic and asymptomatic groups about branches involvement in patients is significant.Initial conservative treatment may be adequate for patients without end organ malperfusion or aneurysm formation or aneurysm rupture in SIDCA.Additionally,during the cooler season,visceral artery should be observed carefully on abdominal contrast CT,especially in the patient with abdominal pain,to avoid misdiagnosis.
