False lumen enhancement characteristics on computed tomography angiography predict risk of aneurysm formation in acute type B aortic dissection.
False lumen enhancement characteristics on computed tomography angiography predict risk of aneurysm formation in acute type B aortic dissection.
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计算机断层扫描血管造影的假腔增强特征可预测急性 B 型主动脉夹层动脉瘤形成的风险。
DOI：
10.1093/icvts/ivab095
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发表时间：
2021
影响因子：
--
通讯作者：
Burris,NicholasS
中科院分区：
文献类型：
--
作者：
Roseland,MollyE;Ahmed,Yunus;vanHerwaarden,JoostA;Moll,FransL;Yang,Bo;Patel,HimanshuJ;Burris,NicholasS
目的真腔(TL)和假腔(FL)之间的不同管腔强化是由不同的血流模式引起的，很可能是由于FL内的流出受限。我们旨在评估急性B型主动脉夹层患者(n= 48)在基线水平的不同管腔增强对不良事件风险的影响。方法应用三维软件分析2007年至2016年间急性B型主动脉夹层患者(n=48)胸腹主动脉下行多个部位的CT血管成像结果。在每个位置测量TL和FL的对比度密度[HU(HU)]、最大直径(Cm)和周向FL范围(°)。结果数据是通过回顾图表收集的。采用多因素Logistic回归模型分析TL-FL差异腔内强化对动脉瘤形成(最大直径≥为55 mm)和治疗失败的独立风险。结果确诊时患者以男性为主(75%)，平均年龄(52.8±12.9) 。平均随访5.9±2.6 年，42%(n= 2 0/48)的患者诊断为胸腹主动脉瘤。在发生动脉瘤的患者中，在原始撕裂口远端2 cm处测量的FL和TL对比密度的绝对差值(TL-FLabs-tear)显著高于发生动脉瘤的患者(26HU，IQR15-53vs13HU，IQR4-24，P= 0.001)。用TL-FLabs-TREAT(优势比1.07，P= 0.012)和基线最大主动脉直径(优势比1.9，P<； 0.001)预测随访期间动脉瘤的发展。高(≥18HU)差异腔强化与较低的无动脉瘤存活率和较高的药物治疗失败率相关。结论差异腔强化可能是急性全身性AD患者动脉瘤形成的新预测因子。
OBJECTIVESDifferential luminal enhancement [between true lumen (TL) and false lumen (FL)] results from differential flow patterns, most likely due to outflow restriction in the FL. We aimed to assess the impact of differential luminal enhancement at baseline computed tomography angiography on the risk of adverse events in patients with acute type B aortic dissection (TBAD).METHODSBaseline computed tomography angiographies of patients with acute TBAD between 2007 and 2016 (n= 48) were analysed using three-dimensional software at multiple sites along the descending thoraco-abdominal aorta. At each location, we measured contrast density in TL and FL [Houndsfield unit (HU)], maximal diameter (cm) and circumferential FL extent (°). Outcome data were collected via retrospective chart review. Multivariable logistic regression models were employed to determine the independent risk of TL–FL differential luminal enhancement on aneurysm formation (maximal diameter ≥55 mm) and medical treatment failure.RESULTSPatients were predominately male (75%) and 52.8±12.9 years at diagnosis. The mean follow-up was 5.9±2.6 years, and 42% (n= 20/48) patients were diagnosed with thoraco-abdominal aortic aneurysm. The baseline absolute difference between FL and TL contrast density measured at 2 cm distal to primary entry tear (TL–FLabs-Tear) was significantly higher among patients who developed aneurysm (26 HU, IQR: 15–53 vs 13 HU, IQR: 4–24,P= 0.001). Aneurysm development during follow-up was predicted by TL–FLabs-Tear(odds ratio 1.07,P= 0.012) and baseline maximal aortic diameter (odds ratio 1.90,P< 0.001). High (≥18 HU) differential luminal enhancement was associated with lower rates of aneurysm-free survival and higher rates of medical treatment failure.CONCLUSIONSDifferential luminal enhancement may be a novel predictor of aneurysm formation among patients with acute TBAD.
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影响因子：
4.6
作者：
Onitsuka, S;Akashi, H;Aoyagi, S
通讯作者：
Aoyagi, S
影响因子：
4.3
作者：
Tsai, Thomas T.;Schlicht, Marty S.;Eagle, Kim A.
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影响因子：
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作者：
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假管腔流量模式及其与慢性主动脉解剖的形态和生物力学特征的关系。与磁共振成像测量值相比，计算模型。
影响因子：
3.7
作者：
Rudenick PA;Segers P;Pineda V;Cuellar H;García-Dorado D;Evangelista A;Bijnens BH
通讯作者：
Bijnens BH
影响因子：
158.5
作者：
Tsai, Thomas T.;Evangelista, Arturo;Eagle, Kim A.
通讯作者：
Eagle, Kim A.