Respiration-induced Deformations of the Superior Mesenteric and Renal Arteries in Patients with Abdominal Aortic Aneurysms
Respiration-induced Deformations of the Superior Mesenteric and Renal Arteries in Patients with Abdominal Aortic Aneurysms
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DOI：
10.1016/j.jvir.2013.04.006
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发表时间：
2013-07-01
影响因子：
2.9
通讯作者：
Cheng, Christopher P.
中科院分区：
文献类型：
--
作者：
Suh, Ga-Young;Choi, Gilwoo;Cheng, Christopher P.
目的：定量研究腹小动脉瘤（AAAs）患者呼吸所致肠系膜上动脉（SMA）、左肾动脉（LRA）、右肾动脉（RRA）的变形。材料和方法：16例男性AAAs患者（73岁±7岁）在吸气和呼气屏气时进行磁共振血管造影成像。通过几何建模和分割技术获得主动脉和内脏动脉的中心线路径。从中心线路径计算呼吸引起的血管平移和分支角度和曲率的变化。结果：在呼气时，SMA、LRA和RRA分岔点向上移动12.4 mm +/- 9.5、14.5 mm +/- 8.8和12.7 mm +/- 6.4 (P < 0.001)，向下移动2.2 mm +/- 2.7、4.9 mm +/- 4.2和5.6 mm +/- 3.9 (P < 0.05)， SMA向右移动3.9 mm 4.9 （P < 0.01）。到期时，SMA、LRA和RRA分别向上倾斜9.7度+/- 6.4度、7.5度+/- 7.8度和4.9度+/- 5.3度（P < 0.005）。随着过期，SMA、LRA和RRA的平均曲率分别增加0.02 mm(-1) +/- 0.01、0.01 mm(-1) +/- 0.01和0.01 mm(-1) +/- 0.01 （P < 0.05）。吸气和呼气时，RRA曲率大于其他血管（P < 0.025）。结论：呼气时，由于膈肌运动，SMA、LRA和RRA向上和向后平移，引起血管分支向上倾斜和曲率增加。此外，SMA表现出向右平移的特征。在呼吸过程中，RRA明显更弯曲，但比其他血管变形少。
Purpose: To quantify respiration-induced deformations of the superior mesenteric artery (SMA), left renal artery (LRA), and right renal artery (RRA) in patients with small abdominal aortic aneurysms (AAAs).Materials and Methods: Sixteen men with AAAs (age 73 y +/- 7) were imaged with contrast-enhanced magnetic resonance angiography during inspiratory and expiratory breath-holds. Centerline paths of the aorta and visceral arteries were acquired by geometric modeling and segmentation techniques. Vessel translations and changes in branching angle and curvature resulting from respiration were computed from centerline paths.Results: With expiration, the SMA, LRA, and RRA bifurcation points translated superiorly by 12.4 mm +/- 9.5, 14.5 mm +/- 8.8, and 12.7 mm +/- 6.4 (P < .001), and posteriorly by 2.2 mm +/- 2.7, 4.9 mm +/- 4.2, and 5.6 mm +/- 3.9 (P < .05), respectively, and the SMA translated rightward by 3.9 mm 4.9 (P < .01). With expiration, the SMA, LRA, and RRA angled upward by 9.7 degrees +/- 6.4, 7.5 degrees +/- 7.8, and 4.9 degrees +/- 5.3, respectively (P < .005). With expiration, mean curvature increased by 0.02 mm(-1) +/- 0.01, 0.01 mm(-1) +/- 0.01, and 0.01 mm(-1) +/- 0.01 in the SMA, LRA, and RRA, respectively (P < .05). For inspiration and expiration, RRA curvature was greater than in other vessels (P < .025).Conclusions: With expiration, the SMA, LRA, and RRA translated superiorly and posteriorly as a result of diaphragmatic motion, inducing upward angling of vessel branches and increased curvature. In addition, the SMA exhibited rightward translation with expiration. The RRA was significantly more tortuous, but deformed less than the other vessels during respiration.