Intraluminal Thrombus Predicts Rapid Growth of Abdominal Aortic Aneurysms
Intraluminal Thrombus Predicts Rapid Growth of Abdominal Aortic Aneurysms
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DOI：
10.1148/radiol.2020191723
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发表时间：
2020-03-01
期刊：
影响因子：
19.7
通讯作者：
Hope, Michael D.
中科院分区：
文献类型：
--
作者：
Zhu, Chengcheng;Leach, Joseph R.;Hope, Michael D.
背景资料：腔内血栓（ILT）内腹主动脉瘤（AAA）可能是一个潜在的标志物为后续的动脉瘤growth.Purpose：探讨ILT在AAA进展的作用，评估与CT和MRI.Materials和Methods：这是一项回顾性研究，患者数据包括从2004年1月至2018年12月在退伍军人事务部医疗中心。纳入了基线时接受造影剂增强CT和随访时接受CT或黑血MRI（最短随访时间为6个月）的AAA男性患者。多平面重建测量AAA最大直径，计算动脉瘤的年增长率。单变量和多变量线性回归分析用于确定人口统计学和成像因素与动脉瘤growth.Results之间的关系：共225例患者（平均年龄72岁+/- 9 [标准差]），平均随访3.3年+/- 2.5年。共207例患者接受了CT随访，18例患者接受了MRI随访。基线时，AAA的中位尺寸为3.8 cm（四分位距[IQR]，3.3-4.3 cm）; 225例患者中有127例（54.7%）患有ILT。与不伴ILT的AAA相比，伴ILT的AAA基线直径更大（中位数，4.1 cm [IQR，3.6-4.8 cm] vs 3.4 cm [IQR，3.2-3.9 cm]; P < .001），生长速度更快（中位数，2.0 mm/y [IQR，1.3-3.2 mm/y] vs 1.0 mm/y [IQR，0.4-1.8 mm/y]; P < .001）。小AAA（大小范围，3-4 cm）伴ILT的生长速度比不伴ILT的快1.9倍（中位数，1.5 mm/y [IQR，0.9-2.7 mm/y] vs 0.8 mm/y [IQR，0.3-1.5 mm/y]; P <0.001）。有ILT的中等AAA（尺寸范围，4-5 cm）的生长速度是无ILT的AAA的1.2倍（中位生长速度，2.1 mm/y [IQR，1.4，3.7 mm/y] vs 1.8 mm/y [IQR，0.9，2.0 mm/y]; P = 0.06）。在多变量分析中，基线直径和ILT与动脉瘤生长率独立正相关（标准回归系数分别为0.43 [P < .001]和0.15 [P = .02]）。结论：动脉瘤最大横截面直径和腔内血栓的存在是腹主动脉瘤生长的独立预测因子。(C)RSNA，2020年
Background: Intraluminal thrombus (ILT) within abdominal aortic aneurysms (AAAs) may be a potential marker for subsequent aneurysm growth.Purpose: To investigate the role of ILT in AAA progression as assessed with CT and MRI.Materials and Methods: This was a retrospective study, with patient data included from January 2004 to December 2018 at a Veteran Affairs medical center. Male patients with AAA who underwent contrast material-enhanced CT at baseline and CT or black-blood MRI at follow-up (minimal follow-up duration of 6 months) were included. The maximal AAA diameter was measured with multiplanar reconstruction, and the annual growth rate of aneurysms was calculated. Uni- and multivariable linear regression analyses were used to determine the relationship between demographic and imaging factors and aneurysm growth.Results: A total of 225 patients (mean age, 72 years +/- 9 [standard deviation]) were followed for a mean of 3.3 years +/- 2.5. A total of 207 patients were followed up with CT, and 18 were followed up with MRI. At baseline, the median size of the AAA was 3.8 cm (interquartile range [IQR], 3.3-4.3 cm); 127 of 225 patients (54.7%) had ILT. When compared with AAAs without ILT, AAAs with ILT had larger baseline diameters (median, 4.1 cm [IQR, 3.6-4.8 cm] vs 3.4 cm [IQR, 3.2-3.9 cm]; P < .001) and faster growth rates (median, 2.0 mm/y [IQR, 1.3-3.2 mm/y] vs 1.0 mm/y [IQR, 0.4-1.8 mm/y]; P < .001). Small AAAs (size range, 3-4 cm) with ILT grew 1.9-fold faster than did those without ILT (median, 1.5 mm/y [IQR, 0.9-2.7 mm/y] vs 0.8 mm/y [IQR, 0.3-1.5 mm/y]; P < .001). Medium AAAs (size range, 4-5 cm) with ILT had 1.2-fold faster growth than did those without ILT (median growth, 2.1 mm/y [IQR, 1.4, 3.7 mm/y] vs 1.8 mm/y [IQR, 0.9, 2.0 mm/y]; P = .06). In multivariable analysis, baseline diameter and ILT were independently positively related to aneurysm growth rate (standardized regression coefficient, 0.43 [P < .001] and 0.15 [P = .02], respectively).Conclusion: Both maximal cross-sectional aneurysm diameter and the presence of intraluminal thrombus are independent predictors of abdominal aortic aneurysm growth. (C) RSNA, 2020