64层螺旋CT测量主动脉壁厚度与冠状动脉疾病的相关性
Correlation between Aortic Wall Thickness and Coronary Artery Disease by 64 Slice Multidetector Computed Tomography.
作者信息
Shakeri Abolhassan, Hafez Quran Farnaz, Javadrashid Reza, Abdekarimi Mohammad Hossein, Ghojazadeh Morteza, Abolghassemi Fakhree Mohammad Bassir
机构信息
Tuberculosis and Pulmonary Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
J Cardiovasc Thorac Res. 2013;5(3):91-5. doi: 10.5681/jcvtr.2013.020. Epub 2013 Oct 5.
INTRODUCTION
Atherosclerotic cardiovascular disease is a dispersed pathology involving the coronary arteries, carotid arteries, aorta and peripheral arteries. It has been previously suggested that coronary and aortic atherosclerosis may be associated. Imaging of the aorta and the aortic wall can be performed by various imaging modalities including state-of-the-art multidetector computer tomography (MDCT). This study aimed to investigate a possible association between the MDCT-measured thickness of the thoracic aorta and the presence of coronary artery disease (CAD) as well as its severity.
METHODS
Three hundred and fifty candidates of coronary computer tomography angiography (CTA) with signs and symptoms suggestive of CAD were recruited in Tabriz Parsian and Iran CTA Centers. Contrast-enhanced MDCT examinations were performed using a 64 detector scanner. Maximum aortic wall thickness in the mid-portion of descending thoracic aorta (region of pulmonary trunk to diaphragm) was measured perpendicular to the center of the vessel.
RESULTS
CAD was confirmed in 189 cases (54%) and the remaining 161 cases served as controls. The mean age of the cases, as well as the percentage of male subjects was significantly higher in the CAD group. The mean aortic wall thickness was also significantly higher in the patient group (2.21±0.63 mm vs. 1.88±0.58 mm; P<0.001). In multivariate analysis, however, the two groups turned up comparable as to the aortic wall thickness (P=0.31). The optimal cut-off point of aortic wall thickness was ≥2 mm in discriminating between CAD+ and CAD- groups, with a corresponding sensitivity and specificity of 65% and 57%, respectively. There was no significant association between aortic wall thickness and the severity of CAD (the number of significantly occluded coronary arteries).
CONCLUSION
Aortic wall thickness is apparently neither an independent predictor of CAD nor is it associated with the severity of CAD in candidates of CTA.
引言
动脉粥样硬化性心血管疾病是一种累及冠状动脉、颈动脉、主动脉和外周动脉的弥漫性病变。此前有研究表明，冠状动脉和主动脉粥样硬化可能存在关联。主动脉及主动脉壁的成像可通过多种成像方式进行，包括先进的多排螺旋计算机断层扫描（MDCT）。本研究旨在探讨MDCT测量的胸主动脉厚度与冠状动脉疾病（CAD）的存在及其严重程度之间的可能关联。
方法
在大不里士帕尔西安和伊朗CTA中心招募了350名有CAD体征和症状提示的冠状动脉计算机断层血管造影（CTA）候选者。使用64排探测器扫描仪进行对比增强MDCT检查。在降主动脉中部（肺动脉干至膈肌区域）垂直于血管中心测量最大主动脉壁厚度。
结果
189例（54%）确诊为CAD，其余161例作为对照。CAD组患者的平均年龄以及男性受试者的比例显著更高。患者组的平均主动脉壁厚度也显著更高（2.21±0.63mm对1.88±0.58mm；P<0.001）。然而，在多变量分析中，两组在主动脉壁厚度方面相当（P=0.31）。在区分CAD+组和CAD-组时，主动脉壁厚度的最佳截断点为≥2mm，相应的敏感性和特异性分别为65%和57%。主动脉壁厚度与CAD的严重程度（严重闭塞冠状动脉的数量）之间无显著关联。
结论
在CTA候选者中，主动脉壁厚度显然既不是CAD的独立预测指标，也与CAD的严重程度无关。
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