摘要
目的:利用多层螺旋计算机体层血管成像(MSCTA)将腹主动脉瘤(AAA)内的附壁血栓(ILT)量化为亨氏单位(HU)值,以探究不同CT值范围内的血栓与AAA破裂风险之间的关系。方法:收集南京鼓楼医院自2017年1月—2021年1月收治的较大直径(≥6.0 cm) AAA患者(共41例)资料,分为腹主动脉瘤完整(IAAA)组(n=25)和腹主动脉瘤破裂(RAAA)组(n=16)。根据每位患者的MSCTA重建三维图像,测量最大横径平面处血栓CT值和不同CT值范围内血栓体积,并在标准化血栓下计算两组中不同CT值范围内血栓的变化。结果:RAAA组最大横径平面处血栓平均CT值[(43.2±8.5)HU]高于IAAA组[(35.7±6.6)HU,P=0.003],且RAAA组最大横径平面处血栓最大CT值中位数(113.0 HU)高于IAAA组(83.0 HU,P<0.001)。进一步分析不同CT值范围内血栓体积,发现在-100~30 HU范围内RAAA组血栓体积[(63.0±35.2)cm3]与IAAA组[(44.2±28.8)cm3]差异无统计学意义(P=0.069);而在30~150 HU范围内RAAA组血栓体积中位数(125.1 cm3)却明显高于IAAA组(78.5 cm3,P=0.010)。在RAAA组中,30~150 HU范围内血栓体积与标准化血栓体积(ILT体积/总瘤腔体积)呈正相关(ρ=0.900,P<0.001),而-100~30 HU范围内两者没有相关性(ρ=0.361,P=0.169)。结论:较大直径的AAA中MSCTA显示的高密度ILT与瘤体破裂相关,高密度ILT可能是高危动脉瘤的特征。
Purpose: To measure the intramural thrombus(ILT) in abdominal aortic aneurysms(AAA) as Hounsfield unit(HU) value by using multi-slice spiral computed tomography angiography(MSCTA), and to explore the relationship between thrombus in the range of different CT values and the risk of AAA rupture.Methods: Patients with large diameter(≥6.0 cm) AAA admitted to Nanjing Drum Tower Hospital from January 2017 to January 2021were divided into intact abdominal aortic aneurysm(IAAA) group(25 cases) and ruptured abdominal aortic aneurysm(RAAA) group(16 cases). CT values of thrombus at the plane of maximum transverse diameter and thrombus volumes in different CT value ranges were measured according to the MSCTA reconstruction in three dimensions in each patient, and the changes in thrombus in different CT value ranges were calculated in both groups under standardized thrombus. Results: The mean CT value of thrombus at the plane of maximum transverse diameter was higher in the RAAA group [(43.2±8.5) HU] than that in the IAAA group [(35.7±6.6) HU, P=0.003], and the median of the maximum CT value of thrombus at the plane of the largest transverse diameter(113.0 HU) in the RAAA group was higher than that in the IAAA group(83.0 HU, P<0.001). Further analysis of the thrombus volume in the different CT value ranges showed that the difference between the thrombus volume in the RAAA group [(63.0±35.2) cm3] and that in the IAAA group [(44.2±28.8) cm3] in the range of-100 HU to 30 HU was with no statistical significance(P=0.069), whereas the median thrombus volume in the RAAA group in the range of 30 HU to 150 HU(125.1 cm3) was significantly higher than that in the IAAA group(78.5 cm3, P=0.010). The thrombus volume in the range of 30 HU to 150 HU in the RAAA group was positively correlated with the standardized thrombus volume(ILT volume/total aneurysms volume;ρ=0.900, P<0.001), while the thrombus volume in the range of-100 HU to 30 HU was negatively correlated with it(ρ =0.361, P=0.169). Conclusion: High-density ILT shown on MSCTA in larger diameter AAA is associated with aneurysm rupture, and high-density ILT may be a characteristic of high-risk aneurysms.
作者
刘和乾
陈志鹏
蔡晶
范海健
麦筱莉
乔彤
LIU Heqian;CHEN Zhipeng;CAI Jing;FAN Haijian;MAI Xiaoli;QIAO Tong(Department of Vascular Surgery,Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical University;Department of Vascular Surgery,Nanjing Drum Tower Hospital,The Afliliated Hospital of Nanjing University Medical School;Department of Radiology,Nanjing Drum Tower Hospital,The Afilated Hospital of Nanjing University Medical School)
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2022年第6期621-626,共6页
Chinese Computed Medical Imaging
基金
国家自然科学基金项目(81870348)。
关键词
腹主动脉瘤
破裂
附壁血栓
高密度
多层螺旋计算机体层血管成像
Abdominal aortic aneurysm
Rupture
Intraluminal thrombus
High density
Multi-slice spiral computed tomography angiography
