基于曲面重建技术构建肾动脉狭窄参数与肾血管性高血压分级的效应关系  

Effect relationship between renal artery stenosis parameters and renovascular hypertension grading based on curved planar reformation technique

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作  者:陈芸[1] 孔倩倩 朱彦[1] 赵天[1] 李月峰[1] CHEN Yun;KONG Qianqian;ZHU Yan;ZHAO Tian;LI Yuefeng(Department of Medical Imaging,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001;Department of Radiology,Jiangsu University of Science and Technology Hospital,Zhenjiang Jiangsu 212003,China)

机构地区:[1]江苏大学附属医院医学影像科,江苏镇江212001 [2]江苏科技大学校医院放射科,江苏镇江212003

出  处:《实用心电学杂志》2024年第6期578-583,共6页Journal of Practical Electrocardiology

基  金:江苏省重点研发计划项目(BE2017698)。

摘  要:目的采用曲面重建(curved planar reformation,CPR)技术探究肾动脉狭窄参数与肾血管性高血压(renovascular hypertension,RVH)分级之间的效应关系。方法回顾性分析34例RVH确诊患者的临床及影像资料,根据高血压分级标准将其分为2级高血压组(18例)和3级高血压组(16例);另收集12例受试者作为健康对照组。对三组分别行肾动脉计算机断层扫描血管成像(computed tomography angiography,CTA)后的图像进行CPR,并测量肾动脉形态学参数(最小管径、最小截面积、管径狭窄比、截面积狭窄比)和血流参数(达阈时间、血流代谢比)。采用单因素方差分析,比较各组肾动脉形态学参数及血流参数。采用Pearson相关性分析,探讨肾动脉形态、血流参数与受试者血压数值的相关性,并利用ROC曲线分析判定截面积狭窄比在不同组中的鉴别诊断效能。结果与对照组相比,高血压组肾动脉的最小管径和最小截面积显著减小,且3级高血压组小于2级高血压组(均P<0.05)。与2级高血压组相比,3级高血压组的管径狭窄比、截面积狭窄比显著增大(均P<0.05),达阈时间显著延长,而血流代谢比显著降低(均P<0.05)。校正的相关性分析显示,截面积狭窄比与舒张压以及收缩压的相关性最为显著(r=0.663,0.671,均P<0.01)。截面积狭窄比在对照组和高血压组、2级高血压组和3级高血压组中均具备良好的鉴别诊断效能(AUC=0.887,P=0.014;AUC=0.818,P=0.027)。结论基于CPR技术的肾动脉形态学参数(管径狭窄比、截面积狭窄比)有望用作RVH的评估和监测指标。Objective To explore the effect relationship between renal artery stenosis parameters and the grading of renovascular hypertension(RVH) by using curved planar reformation(CPR) technique.Methods The clinical and imaging data of 34 subjects specifically diagnosed with RVH were retrospectively analyzed.These patients were divided into grade 2 hypertension group(18 cases) and grade 3 hypertension group(16 cases) according to the hypertension grading standard.Another 12 subjects were enrolled as the healthy control group.The renal artery computed tomography angiography(CTA) was performed on the three groups,and the images were separately made CPR.Additionally,the morphological parameters of renal artery(the minimum pipe diameter,the minimum cross-sectional area,stenosis ratio of pipe diameter and stenosis ratio of cross-sectional area),and hemodynamic parameters(threshold time and bloodflow metabolic ratio) were measured.We compared the renal artery morphological and hemodynamic parameters between groups by using one-way analysis of variance.Pearson correlation analysis was used to explore the correlationship between renal artery morphological or hemodynamic parameters and blood pressure values of the subjects,while ROC curve analysis was applied to evaluate the differential diagnosis efficiency of the stenosis ratio of cross-sectional area among different groups.Results Compared with the control group,the minimum pipe diameter and minimum cross-sectional area of the renal artery were significantly smaller in the hypertension group,while these parameters of the grade 3 hypertension group were smaller than those of the grade 2 hypertension group(all P<0.05).Compared with the grade 2 hypertension group,the stenosis ratio of pipe diameter and stenosis ratio of cross-sectional area in the grade 3 hypertension group were significantly increased(all P<0.05);the threshold time was significantly prolonged,while the bloodflow metabolic ratio significantly decreased in the grade 3 hypertension group(all P<0.05).The corrected co

关 键 词:曲面重建 肾动脉狭窄 高血压 计算机断层扫描血管成像 

分 类 号:R544.14[医药卫生—心血管疾病]

 

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