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腹主动脉瘤腔内修复术后的随访:容积测量与直径测量的比较。

Follow-up of abdominal aortic aneurysm after endovascular aortic repair: comparison of volumetric and diametric measurement.

机构信息

University Medical Center Hamburg-Eppendorf, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, Martinistrasse 52, 20246 Hamburg, Germany.

出版信息

Eur J Radiol. 2012 Jun;81(6):1187-91. doi: 10.1016/j.ejrad.2011.03.065. Epub 2011 Apr 13.

Abstract

PURPOSE

To determine the correlation of maximal diameter measurements with volumetric evaluation of size after endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAA) using computed tomography angiography (CTA) and to survey its applicability for clinical follow-up.

MATERIALS AND METHODS

73 consecutive patients (2 females, 71 males; age 38-84 years; mean age, 69.1 ± 8 years) with AAA were treated with percutaneous EVAR in a single institution. For follow-up, CTA was performed periodically after EVAR. Images were evaluated for maximal diameter in consensus by two experienced radiologists. Using OsirixTM, volumetric measurements were done by one radiologist, including the entire infrarenal abdominal aorta.

RESULTS

In 73 patients 220 CTA examinations were performed after EVAR with a mean follow-up of 17.3 months (range, 1.8-42.7 months). The mean postinterventional volume of aneurysm was 165.63 ml ± 93.29 ml (range, 47.94-565.67 ml). The mean maximal postinterventional diameter was 5.91 ± 1.52 cm (range, 3.72-13.82 cm). At large over the entire observation period a slight, non-significant decrease of 1.6% (2.58ml ± 69.05 ml, range 82.82-201.92 ml) in volumes and a 9.3% (mean 0.55 cm ± 1.22 cm, range 2.85-1.93cm) in diameters were observed. For all examinations a high correlation of volume and diameter was calculated (r = 0.813-0.905; α<0.01).

CONCLUSION

For follow-up of abdominal EVAR using CTA there is a high correlation between volumetric and diametric measurements of aneurysm. Based on a daily clinical routine setting, measurements of maximal diameters in cross sectional imaging of AAA after EVAR seems to be sufficient to exclude post interventional enlargement.

摘要

目的

使用计算机断层血管造影术(CTA)确定腹主动脉瘤(AAA)血管内修复(EVAR)后最大直径测量与体积评估之间的相关性,并调查其在临床随访中的适用性。

材料与方法

在一家机构中,对 73 例连续患者(2 名女性,71 名男性;年龄 38-84 岁;平均年龄 69.1±8 岁)进行经皮 EVAR 治疗。在 EVAR 后,定期进行 CTA 随访。两名有经验的放射科医生通过共识评估图像的最大直径。使用 OsirixTM,一名放射科医生对包括整个肾下腹部主动脉在内的所有体积进行测量。

结果

在 73 例患者中,220 例患者在 EVAR 后进行了 CTA 检查,平均随访时间为 17.3 个月(范围 1.8-42.7 个月)。动脉瘤的平均介入后体积为 165.63ml±93.29ml(范围 47.94-565.67ml)。平均介入后最大直径为 5.91±1.52cm(范围 3.72-13.82cm)。在整个观察期间,体积略有下降,但无统计学意义(1.6%,2.58ml±69.05ml,范围 82.82-201.92ml),直径减少 9.3%(平均 0.55cm±1.22cm,范围 2.85-1.93cm)。所有检查的体积和直径均高度相关(r=0.813-0.905;α<0.01)。

结论

使用 CTA 对腹部 EVAR 进行随访时,动脉瘤的体积和直径测量之间具有高度相关性。在日常临床常规设置的基础上,对 EVAR 后 AAA 的横断面成像中的最大直径进行测量,似乎足以排除介入后扩大。

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