主动脉弓形态与胸主动脉瘤形成相关性分析  

Correlation between aortic arch morphology and thoracic aortic aneurysm formation:a clinical study

作　　者：郝伟丽 申静[2] 张学敬 李彩英[3] 高不郎 HAO Weili;SHEN Jing;ZHANG Xuejing;LI Caiying;GAO Bulang(Department of Medical Research,Shijiazhuang Municipal People’s Hospital,Shijiazhuang,Hebei Province 050011,China)

机构地区：[1]石家庄市人民医院科研中心,050011 [2]河北省胸科医院放射科 [3]河北医科大学附属第二医院放射科

出　　处：《介入放射学杂志》2022年第2期135-138,共4页Journal of Interventional Radiology

基　　金：河北省医学科学研究重点课题计划项目(20190163)。

摘　　要：目的测量胸升主动脉瘤(ATAA)、胸降主动脉瘤(DTAA)患者心脏、主动脉弓形态学参数,探讨胸主动脉瘤形成与主动脉形态学改变的相关性。方法纳入2016年3月至2017年9月在石家庄市人民医院及合作医院接受胸主动脉CTA检查的199例患者,其中ATAA组患者46例,DTAA组患者35例,无主动脉病变正常对照组患者118例。Amira软件重建CTA图像后,分别测量心形角度,心形高度,主动脉弓宽度、高度、角度等形态学参数,比较ATAA组、DTAA组患者与对照组形态学参数的差异。结果单因素分析结果显示,ATAA组、DTAA组弓宽和弓高均大于对照组(P<0.01),ATAA组弓角小于对照组(P=0.028);logistic回归分析显示,弓角是ATAA、DTAA发生的保护因素(b<0,P<0.05),弓宽是危险因素(b>0,P<0.01);受试者工作特征曲线(ROC)分析显示,弓宽、弓高对胸主动脉瘤形成有良好预测价值。结论主动脉弓部形态学改变是胸主动脉瘤形成后的重要特征。弓角较大不利于胸主动脉瘤发生,弓宽、弓高可能成为胸主动脉瘤影像学诊断的预测指标。Objective To measure the morphological parameters of the heart and aortic arch in patients with ascending thoracic aortic aneurysm(ATAA)or with descending thoracic aortic aneurysm(DTAA),and to explore the correlation between aortic arch morphology and thoracic aortic aneurysm formation.Methods A total of 199 consecutive subjects,who received thoracic aortic CTA examination at the Shijiazhuang Municipal People’s Hospital of China between March 2016 and September 2017,were enrolled in this study.Of the199 patients,46 had ATAA(ATAA group),35 had DTAA(DTAA group),and 118 had no aortic aneurysm(control group).Amira software was used to reconstruct CTA images,then,the morphological parameters,including angle of heart,height of heart,arch width,arch height and arch angle,were measured.The results were compared between each other among the three groups.Results Univariate analysis showed that both arch width and arch height in ATAA group and in DTAA group were larger than those in the control group(P<0.01),and the arch angle in ATAA group was smaller than that in the control group(P=0.028).Logistic regression analysis indicated that the arch angle was a protective factor for both ATAA and DTAA(b<0,P<0.05),while the arch width was a risk factor(b>0,P<0.01).Receiver operating characteristic(ROC)curve analysis revealed that both arch width and arch height were of great value in predicting the formation of thoracic aortic aneurysm.Conclusion The morphological changes of aortic arch are important features of thoracic aortic aneurysm formation.A larger arch angle is not conducive to the occurrence of thoracic aortic aneurysm,and both arch width and arch height may become the predicting indexes for imaging diagnosis of thoracic aortic aneurysm.

关 键 词：胸主动脉瘤 主动脉弓宽度 主动脉弓高度 主动脉弓角 形态学 

分 类 号：R564.2[医药卫生—呼吸系统]