Preliminary findings in quantification of changes in septal motion during follow-up of type B aortic dissections
Preliminary findings in quantification of changes in septal motion during follow-up of type B aortic dissections
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DOI：
10.1016/j.jvs.2011.10.127
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发表时间：
2012-05-01
影响因子：
4.3
通讯作者：
Bismuth, Jean
中科院分区：
文献类型：
--
作者：
Karmonik, Christof;Duran, Cassidy;Bismuth, Jean
目的：采用二维（2D）相位对比磁共振成像量化动脉内间隔（IS）运动的纵向变化目的：探讨二维磁共振成像（2D pcMRI）在B型主动脉夹层（AD）中的应用价值，以提高对AD及其中期发展的认识。从42名在卫理公会DeBakey心脏和心脏病中心的急性主动脉治疗中心接受动态磁共振成像（MRI）检查的患者的数据库中，血管中心，10例B型AD患者的短期（平均6.6天;范围1-10天; n = 7）和中期随访（平均155天;范围60-324; n = 5）2D pcMRI图像数据可用。IS运动被量化为在心动周期上平均的IS边界点的运动。IS运动的相对变化表示为与初始呈现相比的百分比变化。最大IS扩展（真腔[TL]扩张）和收缩（TL压缩）、IS分数与主动脉血流同相以及IS运动与主动脉血流的相关性结果：初始出现时IS运动为0.68 +/- 0.2 mm，在短期内减少（0.48 +/- 0.3 mm; P = 0.07）和中期（0.5 +/- 0.2 mm; P = 0.1）随访。短期随访期间IS运动相对变化的趋势是可变的：3例受试者（-75% +/-6%）减少，4例受试者（48% +/-23%）增加。在中期随访期间，4例受试者（28% +/- 19%）的IS运动相对变化减少，1例受试者（6.2%）的IS运动相对变化略有增加。随随访，IS收缩减少，而IS伸展略有增加。与主动脉血流同相移动的IS分数增加，但IS顺应性下降，这表明增加IS stiffness.Conclusions：短期和中期随访可见AD中IS运动减少。这种趋势的受试者间变异性在短期随访时较高，但在中期随访时较低。对IS运动参数的详细分析表明IS收缩和IS顺应性随时间减少。这对B型主动脉夹层的血管内治疗具有潜在意义，因为主动脉覆膜支架的扩张可能受到僵硬IS的限制。（J Vasc Surg 2012;55：1419-26.）
Objective: To quantify longitudinal changes in intra-arterial septum (IS) motion with two-dimensional (2D) phase-contrast magnetic resonance imaging (2D pcMRI) in type B aortic dissections (AD) to improve the understanding of AD and its midterm development.Methods: From a database of 42 patients who underwent a dynamic magnetic resonance imaging (MRI) examination at the Acute Aortic Treatment Center of The Methodist DeBakey Heart & Vascular Center, 2D pcMRI image data was available from 10 patients with type B AD for both short-term (mean, 6.6 days; range, 1-10 days; n = 7) and midterm follow-up (mean, 155 days; range, 60-324; n = 5). IS motion was quantified as motion of IS boundary points averaged over the cardiac cycle. Relative change in IS motion was expressed as percent change compared with initial presentation. Maximum IS extension (true lumen [TL] expansion) and contraction (TL compression), IS fraction in phase with aortic flow and correlation of IS motion with aortic flow (IS compliance) were quantified.Results: IS motion at initial presentation was 0.68 +/- 0.2 mm and was reduced at short-term (0.48 +/- 0.3 mm; P = .07) and midterm (0.5 +/- 0.2 mm; P = .1) follow-up. Trend in relative change of IS motion was variable during short-term follow-up: reduced in three subjects (-75% +/- 6%) and elevated in four subjects (48% +/- 23%). During midterm follow-up, relative change in IS motion was reduced in four subjects (28% +/- 19%) and slightly elevated in one (6.2%). IS contraction decreased with follow-up while IS extension slightly increased. Fraction of IS moving in phase with aortic flow increased but IS compliance decreased, suggesting increasing IS stiffness.Conclusions: Reduction of IS motion in AD is seen with short-term and midterm follow-up. Intersubject variability of this trend is high at short-term follow-up but low at midterm follow-up. Detailed analysis of IS motion parameters indicate reduction of IS contraction and IS compliance with time. This has potential implications for endovascular management of type B aortic dissections, as expansion of aortic stent grafts can be limited by a stiff IS. (J Vasc Surg 2012;55:1419-26.)