形态学参数在评估肠系膜上动脉瘤稳定性中的价值  

Role of Morphological Parameters in Evaluating the Stability of Superior Mesenteric Artery Aneurysms

作　　者：陈维翠[1] 毛礼厅 唐业欢 侯小燕[1] 张汉良[1] 刘岘[1] 刘国清[1] CHEN Weicui;MAO Litin;TANG Yehuan(Department of Radiology,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou,Guangdong Province 510120,P.R.China)

机构地区：[1]广东省中医院(广州中医院大学附属第二医院)放射科,广州510120 [2]广西医科大学第一附属医院放射科,南宁530021

出　　处：《临床放射学杂志》2020年第8期1528-1532,共5页Journal of Clinical Radiology

摘　　要：目的探讨肠系膜上动脉瘤(SMAA)形态学参数在评估SMAA稳定性中的价值。方法回顾性分析26例SMAA患者的CTA图像,并根据动脉瘤是否破裂分为破裂组(n=10)与未破裂组(n=16),比较两组患者年龄、吸烟史、收缩压、舒张压、动脉瘤的形态、发生部位及二维几何参数,包括径线比(瘤体最大径线或垂直径线/载瘤血管直径)、面积比(瘤体最大径线或垂直径线处的截面积/载瘤血管的截面积)是否存在统计学差异。结果两组患者年龄、吸烟史、收缩压、舒张压及动脉瘤发生部位差异无统计学意义。破裂组径线比为3.9±1.0,面积比为10.3(10.1),均大于未破裂组径线比2.3±0.8,面积比3.2(5.1)(P<0.01,P=0.004),破裂组囊状动脉瘤的比例(90%)高于未破裂组(37.5%)(P=0.014)。结论SMAA破裂组中的径线比、面积比较未破裂组相对增大,提示径线比、面积比可能是评估SMAA破裂的重要形态学参数;囊状动脉瘤较梭形动脉瘤破裂风险增高。Objective Role of morphological parameters in evaluating the stability of superior mesenteric artery aneurysm(SMAA)was investigated.Methods We prospectively enrolled 26 consecutive patients presenting to a single institution with either ruptured SMAA(n=10)or an incidental SMAA(n=16).Blinded technologists acquired all measurements from CTA images.Test was performed to assess statistical significance in age,smoking history,blood pressure,aneurysm form,location,diameter ratio(DR)and area ratio(AR)between ruptured and unruptured groups.The DR was calculated by dividing the aneurysm maximum or vertical diameter(mm)by the average parent vessel diameter(mm).The AR was calculated by dividing the cross-sectional aneurysm area at the slice of maximum or vertical diameter by parent vessel lumen area.Results No significant differences were found in age,smoking status,blood pressure and location between ruptured and unruptured groups.The unruptured group had significantly smaller DR value and AR value[2.3±0.8,3.2(5.1)]compared with the ruptured group[3.9±1.0,10.3(10.1)].The proportion of saccular aneurysms(90%)in ruptured SMAAs was significantly higher compared with the unruptured SMAAs(37.5%,P=0.014).Conclusion DR value and AR value are increased in ruptured SMAAs compared to unruptured SMAAs,which may support the important role of DR and AR in evaluating the stability of SMAAs.Cystic aneurysms demonstrated higher rupture risk than fusiform aneurysms.

关 键 词：肠系膜上动脉瘤 面积比 径线比 破裂 体层摄影术 X线计算机 

分 类 号：R572.3[医药卫生—消化系统] R816.5[医药卫生—内科学]