COMPUTED-TOMOGRAPHY SCANNING FINDINGS ASSOCIATED WITH RAPID EXPANSION OF ABDOMINAL AORTIC-ANEURYSMS
COMPUTED-TOMOGRAPHY SCANNING FINDINGS ASSOCIATED WITH RAPID EXPANSION OF ABDOMINAL AORTIC-ANEURYSMS
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DOI：
10.1016/0741-5214(94)90277-1
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发表时间：
1994-10-01
影响因子：
4.3
通讯作者：
BERNSTEIN, EF
中科院分区：
文献类型：
--
作者：
WOLF, YG;THOMAS, WS;BERNSTEIN, EF
目的：腹主动脉瘤（AAA）的早期修复特别适用于最有可能扩张的腹主动脉瘤。我们的目的是定义功能的计算机断层扫描（CT）扫描与随后的快速动脉瘤expansion.Methods：我们回顾了80例AAA（>3.0厘米）谁进行了腹部和骨盆CT扫描两次，至少相隔6个月，在1986年和1992年之间的CT扫描。动脉瘤最初测量为4.4 ± 0.6 cm，获得扫描的平均间隔为22 ± 12个月。评估的临床变量包括年龄、性别、医学风险因素、基础心血管和肺部疾病以及β受体阻滞剂和降脂药的给药。每个CT扫描切片的计算机辅助测量包括动脉瘤的最大和最小直径和面积。管腔血栓尺寸和血栓覆盖的动脉瘤壁尺寸（TARC）。最大动脉瘤尺寸与近肾主动脉和第二腰椎椎体尺寸有关。结果：平均动脉瘤扩张为0.26 +/- 0.25 cm/yr。与扩张率显著相关的CT扫描变量包括平均TARC（r = 0.43，p < 0.001）、血栓体积分数（r = 0.37，p < 0.001）、最大动脉瘤横截面上的TARC（r = 0.34，p < 0.01）和血栓面积分数（r = 0.30，p < 0.01）。15例（19%）动脉瘤发生快速扩张（>0.5 cm/年）。Logistic回归分析显示，AAA快速扩张的两个预测因子分别为平均TARC（p < 0.005）和颈动脉疾病（p < 0.05）。结论：AAA血栓负荷增加与AAA快速扩张的可能性增加相关，应考虑早期手术修复。
Purpose: Early repair of abdominal aortic aneurysms (AAA) is particularly appropriate for those that are most likely to expand. Our aim was to define features on computed tomography (CT) scanning associated with subsequent rapid aneurysm expansion.Methods: We reviewed CT scans of 80 patients with AAA (>3.0 cm) who underwent CT scanning of the abdomen and pelvis two times, at least 6 months apart, between 1986 and 1992. The aneurysms initially measured 4.4 +/- 0.6 cm, and the mean interval between obtaining scans was 22 +/- 12 months. Clinical variables assessed included age, sex, medical risk factors, underlying cardiovascular and pulmonary diseases, and administration of beta blockers and Lipid-lowering agents. Computer-aided measurements on each CT scan section included the maximal and minimal diameters and area of the aneurysm. Dimensions of the luminal thrombus and the are of aneurysm wall covered by thrombus (TARC). Maximal aneurysm dimensions were related to juxtarenal aortic and second lumbar vertebral body dimensions.Results: Mean aneurysm expansion was 0.26 +/- 0.25 cm/yr. CT scanning variables that correlated significantly with rate of expansion included the mean TARC (r = 0.43, p < 0.001), thrombus volume fraction (r = 0.37, p < 0.001), TARC on the largest aneurysm cross section (r = 0.34, p < 0.01), and thrombus area fraction (r = 0.30, p < 0.01). Rapid expansion (>0.5 cm/yr) occurred in 15 (19%) aneurysms. The two predictors for rapid expansion on logistic regression analysis were mean TARC (p < 0.005) and the presence of carotid artery disease (p < 0.05).Conclusion: An increased AAA thrombus load is associated with a higher Likelihood of rapid expansion and should weigh in favor of early surgical repair.