主动脉夹层患者术前主动脉CTA扫描参数与术后主动脉重构的关系研究  

Relationship between preoperative aortic CTA scan parameters and postoperative aortic remodeling in patients with aortic dissection

作　　者：范璐[1] 孙玮[1] 李姝琪 崔聪[2] Fan Lu;Sun Wei;Li Shuqi;Cui Cong(Medical Imaging Department of the Second Affiliated Hospital of Zhengzhou University,Zhengzhou,450000,China;不详)

机构地区：[1]郑州大学第二附属医院医学影像科,郑州450000 [2]河南省胸科医院心血管外科八病区(大血管外科),郑州450000

出　　处：《中国循证心血管医学杂志》2023年第10期1199-1202,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：2018年河南省医学科技攻关计划(2018020550)。

摘　　要：目的研究主动脉夹层(AD)患者术前主动脉CT血管造影(CTA)扫描参数与术后主动脉重构的关系。方法选取2021年1月至2022年1月于郑州大学第二附属医院收治的AD患者150例,均行胸主动脉腔修复术,统计随访6个月术后主动脉重构情况。将主动脉重构阳性患者作为阳性组,主动脉重构阴性患者为阴性组。比较两组术前CTA征象,采用Logistic回归分析法分析术前CTA征象与术后主动脉重构的关系;建立受试者工作特征曲线(ROC)评价术前CTA征象对术后主动脉重构阴性的预测效能。结果所有患者均随访至术后6个月,经CTA检查显示,真腔面积占比阳性平面计数>1/2的患者109例(72.67%),设为阳性组,真腔面积占比阳性平面计数≤1/2的患者41例(27.33%),设为阴性组。与阳性组比较,阴性组主动脉管壁厚度增加(P<0.05),动脉壁环形或新月形增厚、升主动脉逆行撕裂及主动脉弓部破口构成比升高(P<0.05)。ROC曲线显示,主动脉管壁厚度预测术后主动脉重构阴性的最佳截断点为2.17 mm,主动脉管壁厚度、动脉壁环形或者新月形增厚、升主动脉逆行撕裂、主动脉弓部破口预测术后主动脉重构阴性的AUC分别为0.790、0.731、0.751、0.799。结论AD患者术前主动脉CTA扫描参数中主动脉管壁厚度、动脉壁环形或者新月形增厚、升主动脉逆行撕裂及主动脉弓部破口与术后主动脉重构关系密切,可为临床评估该病预后提供参考依据。Objective To study the relationship between preoperative aortic CTA scan parameters and postoperative aortic remodeling in patients with aortic dissection(AD).Methods A total of 150 AD patients admitted to Medical Imaging Department of the Second Affiliated Hospital of Zhengzhou University from January 2021 to January 2022 were selected and underwent thoracic aortic cavity repair.After 6 months of follow-up,the postoperative aortic remodeling was counted,and patients with positive aortic remodeling were set as the positive group,and patients with negative aortic remodeling were set as the negative group.The preoperative CTA signs were compared between the two groups.Logistic regression analysis was used to analyze the relationship between preoperative CTA signs and postoperative aortic remodeling.A receiver operating characteristic(ROC)curve was established to evaluate the predictive power of preoperative CTA signs on negative postoperative aortic remodeling.Results All patients were followed up to 6 months after operation.The CTA examination showed that 109 patients(72.67%)with true cavity area accounting for more than 1/2 of the positive plane count were set as the positive group,there were 41 patients(27.33%)whose true cavity area accounted for≤1/2 of the positive plane count and were set as the negative group.Compared with the positive group,the aortic wall thickness was increased(P<0.05),the annular or crescent thickening of the artery wall,the retrograde tear of the ascending aorta and the aortic arch rupture ratio were increased in the negative group(P<0.05).ROC curve showed that the optimal cut-off point of aortic wall thickness for predicting negative postoperative aortic remodeling was 2.17 mm.The AUC of aortic wall thickness,annular or crescent thickening,retrograde tear of ascending aorta,and aortic arch rupture for predicting negative postoperative aortic remodeling were 0.790,0.731,0.751,and 0.799,respectively.Conclusion Preoperative aortic CTA scan parameters in AD patients are closely related to

关 键 词：主动脉夹层 CT血管造影 主动脉重构 

分 类 号：R543.1[医药卫生—心血管疾病]