Quantitative analysis of renal blood flow during thoracic endovascular aortic repair in type B aortic dissection using syngo iFlow
Quantitative analysis of renal blood flow during thoracic endovascular aortic repair in type B aortic dissection using syngo iFlow
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使用 syngo iFlow 定量分析 B 型主动脉夹层胸主动脉腔内修复术中肾血流量
DOI：
10.21037/qims-20-992
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发表时间：
2021-08-01
影响因子：
2.8
通讯作者：
Shu, Chang
中科院分区：
文献类型：
--
作者：
Fang, Kun;Zhao, Jiawei;Shu, Chang
背景：目前，胸主动脉腔内修复术是B型主动脉夹层的推荐临床治疗方法。不幸的是，肾灌注不良或缺血是B型主动脉夹层的主要并发症。尽管如此，很少有研究关注胸主动脉腔内修复术对肾动脉和实质血流的影响。本研究采用新型实时成像软件定量分析覆膜支架置入前后肾动脉血流和灌注的血流动力学变化。方法：回顾性纳入2017年4月至2019年9月行胸主动脉腔内修复术的B型主动脉夹层患者共51例。使用syngo iFlow将术前和术后数字减影血管造影图像转换为彩色编码图，以进行定量比较。分析肾动脉和肾皮质的时间-强度曲线及相关参数，包括平均峰值比（avg.Pr）、平均达峰延迟时间（avg.dTTP）和平均曲线下面积比（avg.AUCr）。使用Wilcoxon符号秩检验比较腔内修复术前后的iFlow参数。结果：102张图像（术前51张，术后51张）均成功完成后处理，其中术前102张，术后102张。腔内修复术后，syngo iFlow显示平均Pr显著增加33.0%（P
Background: Currently, the thoracic endovascular aortic repair is the recommended clinical treatment for type B aortic dissections. Unfortunately, malperfusion or ischemia of the kidneys is a major complication of type B aortic dissections. Despite this, few studies have focused on the effects of thoracic endovascular aortic repair on blood flow in renal arteries and parenchyma. This current investigation used novel realtime imaging software to quantitatively analyze the hemodynamic changes in renal artery blood flow and perfusion before and after stent graft placement.Methods: A total of 51 patients with type B aortic dissection undergoing thoracic endovascular aortic repair between April 2017 and September 2019 were retrospectively recruited. The pre- and post-procedural digital subtraction angiography images were converted into color-coded maps using syngo iFlow for quantitative comparison. Time-intensity curves and related parameters, including the average peak ratio (avg.Pr), average delayed time to peak (avg.dTTP), and average area under the curve ratio (avg.AUCr) of the renal arteries and renal cortex were obtained and analyzed. Wilcoxon signed-rank test was used to compare iFlow parameters before and after endovascular repair. Spearman correlation analyses were performed to study iFlow parameters and renal function parameters and the estimated glomerular filtration rate (eGFR) and blood urea nitrogen (BUN).Results: A total of 102 images including 51 pre-operative and 51 post-operative image datasets were successfully post-processed. Following endovascular repair, syngo iFlow showed a significant 33.0% increase in avg.Pr (P