The diagnostic value of CT angiography in traumatic pelvic artery pseudoaneurysm and dissecting aneurysm_West China Medical Journal

Authors：

FU Quanshui ,  YANG Guoqing , HU Na , CHEN Hong

Department of Radiology, Suining Central Hospital, Suining, Sichuan 629000, P. R. China;

Corresponding author：

YANG Guoqing, Email: yangguoqingygq@aliyun.com

Keywords：

Pseudoaneurysm; Dissecting aneurysm; Pelvic artery; Angiography; Digital substraction angiography

DOI：

10.7507/1002-0179.201604266

Video：

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Objective To discuss the clinical application value of CT angiography (CTA) in traumatic pelvic artery pseudoaneurysm and dissecting aneurysm. Methods A total of 8 patients including 7 with traumatic pelvic artery pseudoaneurysm and 1 with dissecting aneurysm diagnosed by CTA in Suining Central Hospital from August 2012 to January 2016 were enrolled in this study, in whom 6 patients with traumatic pseudoaneurysm treated with embolotherapy were confirmed by digital subtraction angiography. Image post-processing techniques of CTA including curve planar reformation, multiplanar reconstruction and volume rendering were used. Results In the seven patients diagnosed as solitary traumatic pelvic artery pseudoaneurysm by CTA, 3 had superior gluteal artery pseudoaneurysm, 2 had inferior gluteal artery pseudoaneurysm, and 2 had external iliac artery pseudoaneurysm. The 7 pseudoaneurysms were pouch-shaped with the short diameters ranged from 9 to 64 mm and the long diameters ranged from 11 to 78 mm. Six locations of artery laceration were displayed clearly, thereinto 1 case was combined with arteriovenous fistula. In addition, a vessel occlusion caused by the limitation of right external iliac artery dissecting aneurysm and the thrombosis in left side of the external iliac artery was found in 1 case. Conclusions As a non-invasive diagnostic technique, CTA can accurately diagnose traumatic pelvic artery pseudoaneurysm and dissecting aneurysm, clearly display the location relationship of pseudoaneurysm and its parent artery, and find whether arteriovenous fistula exists. Beyond that, the true and false lumen of dissecting aneurysm can be precisely identified by this technique. CTA can provide important image information for formulating individual treatment plan.

Citation： FU Quanshui, YANG Guoqing, HU Na, CHEN Hong. The diagnostic value of CT angiography in traumatic pelvic artery pseudoaneurysm and dissecting aneurysm. West China Medical Journal, 2017, 32(10): 1551-1554. doi: 10.7507/1002-0179.201604266 Copy

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4.	王吉东, 方挺松, 彭加友, 等. 64 排螺旋 CT 血管造影技术在下肢动脉损伤中的应用. 海南医学, 2014, 25(1): 44-46.
5.	龙晚生, 胡茂清, 黄列彬, 等. 腹盆腔动静脉瘘的 MSCT 诊断. 中国 CT 和 MRI 杂志, 2014, 12(1): 98-100.
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7.	张建廷, 郗二平, 陈刚, 等. 外伤性假性动脉瘤与动静脉瘘的血管造影表现及治疗. 实用放射学杂志, 2012, 28(2): 280-282.
8.	厉兰, 资晓宏. 外伤致颈内动脉夹层动脉瘤一例. 医学临床研究, 2012, 29(3): 591-592, 封3.
9.	Aladham F, Sundaram B, Williams DM, et al. Traumatic aortic injury: computerized tomographic findings at presentation and after conservative therapy. J Comput Assist Tomogr, 2010, 34(3): 388-394.
10.	Alkadhi H, Wildermuth S, Desbiolles L, et al. Vascular emergencies of the thorax after bluntand iatrogenic trauma: multi-detector row CT and three-dimensional imaging. Radiographics, 2004, 24(5): 1239-1255.
11.	Litmanovich D, Bankier AA, Cantin L, et al. CT and MRI in diseases of the aorta. AJR Am J Roentgenol, 2009, 193(4): 928-940.
12.	潘旭东, 孙立忠, 郑军. 主动脉夹层易感因素和细胞外基质关系的研究进展. 中国综合临床, 2006, 22(10): 955-957.
13.	薛凌, 罗建方, 刘媛, 等. 动脉粥样硬化危险因素在急性主动脉夹层患者中的分布. 中国动脉硬化杂志, 2008, 16(11): 899-901.
14.	张茂, 徐善祥, 干建新, 等. 钝性外伤性主动脉夹层救治 1 例报道. 中国急救医学, 2005, 25(5): 369.
15.	张源明, 周立英, 何秉贤, 等. 主动脉夹层 106 例的临床分析. 中华心血管病杂志, 2005, 33(6): 536-538.
16.	赵克洪, 沈江明. 高龄老年患者颈动脉粥样硬化与心血管危险因素及缺血性脑卒中的相关规律. 中国组织工程研究, 2004, 8(13): 2420-2421.

1. Perry MO. Complications of missed arterial injuries. J Vasc Surg, 1993, 17(2): 399-407.
2. Dongola NA, Giles JA, Guy RL. Embolisation of a post-traumatic superior gluteal arteryaneurysm: case report. East Afr Med J, 2004, 81(8): 433-435.
3. 金凯, 董飞, 闵捷, 等. 刀刺伤后 20 年迟发性臀动脉假性动脉瘤一例. 中华创伤杂志, 2015, 31(2): 191-192.
4. 王吉东, 方挺松, 彭加友, 等. 64 排螺旋 CT 血管造影技术在下肢动脉损伤中的应用. 海南医学, 2014, 25(1): 44-46.
5. 龙晚生, 胡茂清, 黄列彬, 等. 腹盆腔动静脉瘘的 MSCT 诊断. 中国 CT 和 MRI 杂志, 2014, 12(1): 98-100.
6. 易峰涛, 魏崇健, 宋华志, 等. 外伤性假性动脉瘤与动静脉瘘的影像学研究及介入治疗. 实用医学杂志, 2010, 26(21): 3967-3969.
7. 张建廷, 郗二平, 陈刚, 等. 外伤性假性动脉瘤与动静脉瘘的血管造影表现及治疗. 实用放射学杂志, 2012, 28(2): 280-282.
8. 厉兰, 资晓宏. 外伤致颈内动脉夹层动脉瘤一例. 医学临床研究, 2012, 29(3): 591-592, 封3.
9. Aladham F, Sundaram B, Williams DM, et al. Traumatic aortic injury: computerized tomographic findings at presentation and after conservative therapy. J Comput Assist Tomogr, 2010, 34(3): 388-394.
10. Alkadhi H, Wildermuth S, Desbiolles L, et al. Vascular emergencies of the thorax after bluntand iatrogenic trauma: multi-detector row CT and three-dimensional imaging. Radiographics, 2004, 24(5): 1239-1255.
11. Litmanovich D, Bankier AA, Cantin L, et al. CT and MRI in diseases of the aorta. AJR Am J Roentgenol, 2009, 193(4): 928-940.
12. 潘旭东, 孙立忠, 郑军. 主动脉夹层易感因素和细胞外基质关系的研究进展. 中国综合临床, 2006, 22(10): 955-957.
13. 薛凌, 罗建方, 刘媛, 等. 动脉粥样硬化危险因素在急性主动脉夹层患者中的分布. 中国动脉硬化杂志, 2008, 16(11): 899-901.
14. 张茂, 徐善祥, 干建新, 等. 钝性外伤性主动脉夹层救治 1 例报道. 中国急救医学, 2005, 25(5): 369.
15. 张源明, 周立英, 何秉贤, 等. 主动脉夹层 106 例的临床分析. 中华心血管病杂志, 2005, 33(6): 536-538.
16. 赵克洪, 沈江明. 高龄老年患者颈动脉粥样硬化与心血管危险因素及缺血性脑卒中的相关规律. 中国组织工程研究, 2004, 8(13): 2420-2421.

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The diagnostic value of CT angiography in traumatic pelvic artery pseudoaneurysm and dissecting aneurysm

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