多层螺旋CT评估主动脉瓣狭窄所致主动脉根部参数改变  

Multi-detector CT for evaluating aortic root parameters changes caused by aortic stenosis

作　　者：张帅 黄霆[2] 郭茜 尚全良[2] ZHANG Shuai;HUANG Ting;GUO Xi;SHANG Quanliang(Department of Radiology and Imaging,Wuzhong People's Hospital,Wuzhong 751100,China;Department of Radiology,the Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]吴忠市人民医院放射影像科,宁夏吴忠751100 [2]中南大学湘雅二医院放射科,湖南长沙410011

出　　处：《中国医学影像技术》2025年第3期419-423,共5页Chinese Journal of Medical Imaging Technology

基　　金：湖南省自然科学基金(2023JJ60084)。

摘　　要：目的观察多层螺旋CT(MDCT)评估主动脉瓣狭窄(AS)所致主动脉根部参数改变的价值。方法回顾性分析20例重度AS患者MDCT资料,测算其主动脉瓣环(AA)、左心室流出道(LVOT)及窦管交界处(STJ)在收缩早期、收缩晚期、舒张早期及舒张晚期的长径、短径、平均直径、面积、周长,以及面积衍生径(DA)和周长衍生径(DC)变化。结果收缩早期AA短径、平均直径、面积、周长、DA及DC均大于收缩晚期、舒张早期及舒张晚期(P均<0.05);AA长径各期相间差异均无统计学意义(P均>0.05)。收缩早期LVOT短径、平均直径、面积、周长、DA及DC均大于收缩晚期、舒张早期及舒张晚期(P均<0.05);LVOT收缩早期长径大于收缩晚期(P<0.05),而与舒张早期及舒张晚期差异均无统计学意义(P均>0.05)。STJ各参数各期相间差异均无统计学意义(P均>0.05)。收缩早期AA的DA及平均直径均明显小于DC(P均<0.05)。结论以MDCT测量重度AS患者AA相关参数可为经导管主动脉瓣置换术中选择人工瓣膜提供重要参考。Objective To observe the value of multi-detector CT(MDCT)for evaluating changes of aortic root parameters caused by aortic stenosis(AS).Methods MDCT data of 20 cases with severe AS were retrospectively analyzed.The changes of the long diameter,short diameter,mean diameter,area,circumference,as well as diameter derived from area(DA)and diameter derived from circumference(DC)of aortic annulus(AA),left ventricular outflow tract(LVOT)and sinotubular junction(STJ)during early systole,late systole,early diastole and late diastole were measured and calculated,respectively.Results In early systole,the short diameter,mean diameter,area,circumference,DA and DC of AA were all significantly larger than that those in late systole,early diastole and late diastole(all P<0.05).No significant difference of the long diameter of AA was found among different phases(all P>0.05).Meanwhile,the short diameter,mean diameter,area,circumference,DA and DC of LVOT in early systole were all significantly larger than those in late systole,early diastole and late diastole(all P<0.05).The long diameter of LVOT in early systole was larger than in late systole(P<0.05),but not significantly different compared with that in early and late diastole(both P>0.05).No significant difference of the above parameters of STJ was found among different phases(all P>0.05).At early systole,DA and the mean diameter of AA were both significantly smaller than those of DC(both P<0.05).Conclusion AA parameters obtained with MDCT in patients with severe AS were valuable for selecting prosthetic valves during transcatheter aortic valve replacement.

关 键 词：主动脉瓣狭窄 经导管主动脉瓣置换术 体层摄影术 X线计算机 

分 类 号：R543.1[医药卫生—心血管疾病] R814.42[医药卫生—内科学]