Hemorrhagic Pulmonary Sheath Due to Ruptured Acute Stanford A Aortic Dissection:Incidence,CT Appearance and Consequences / 中山大学学报(医学科学版)

ABSTRACT

[Objective]To retrospectively investigate the incidence,computed tomography(CT)manifestations and consequences of hemorrhagic pulmonary sheath(HPS)in Stanford A aortic dissection(AD)patients.[Methods]Institu-tional review board approval and informed consents were obtained.CT aortic angiography images of 188 consecutive acute Stanford A aortic dissection patients(mean age,59 years;range29-78 years;136 males,52 females)were reviewed. CT images were interpreted by two independent radiologists.Clinical records were reviewed for outcomes of patients up to 30 days after the initial CT scan.[Results]18(9.6%)out of 188 patients had HPS.Right pulmonary artery was involved in 9(50%),left pulmonary artery in 2(11.1%)and both in 7(38.9%)of the 18 patients respectively.HPS extending along bronchovascular sheaths(TypeⅡ)was identified in 9(50%)of 18 patients,and 7(77.8%)of them had alveolar opacity around the thickened bronchovascular sheath. Within 30 days of follow-up,61.1%(11/18)patients died and 38.9%(7/18)patients survived with absorption of HPS.TypeⅡHPS was more prevalent in death group(7/11,63.6%) than survival group(2/7,28.6%),but not statistically significant(P=0.335).Patients in death group were more likely to have abdominal visceral arteries involvement(7/11,63.6%)than patients in survival group(0/7,0%)(P=0.010).[Conclusion]HPS was not a rare complication in patients with Stanford A AD.Abdominal visceral arteries involvement in-dicated poor short-term outcome in this study.