Heilmaier Christina, Koester Astrid, Moysidis Theodoros, Weishaupt Dominik, Kröger Knut
Department of Radiology, Stadtspital Triemli, Zürich, Switzerland.
Helios Klinikum Krefeld.
Vasa. 2014 Mar;43(2):132-40. doi: 10.1024/0301-1526/a000339.
Multi-detector computed tomography (MDCT) is more and more used for evaluation and quantification of coronary artery calcification, but correlation between the degree of calcification and occurrence of clinical events is also known for other vascular beds such as the aorta.
To assess possible differences in amount and pattern of calcification in aneurysmatic and non-aneurysmatic abdominal aortas.
Thirty-four subjects displayed infrarenal abdominal aneurysm (AAA) and were compared to 33 patients with normal-sized aortas using MDCT. Quantitative and qualitative analysis was performed by two radiologists. Calcium scores were assessed for the whole abdominal aorta as well as separately for the supra- and infrarenal segments. Moreover, plaque patterns were evaluated and classified according to their thickness and size. Furthermore, calcium scores were correlated with a number of cardiovascular risk factors.
Total calcium scores were comparable in patients with and without AAA (1,213 ± 1,351 and 1,211 ± 1,535, respectively), but significant differences were found regarding plaque density that was considerably higher both in the supra- and infrarenal segments in the non-aneurysmatic group (AAA: suprarenal, 0.01, infrarenal, 0.07; non-AAA: suprarenal, 0.06, infrarenal, 0.16). Plaque pattern were considerably different in the infrarenal segments in aneurysmatic aortas: they were thinner (1 and 2 mm) and smaller (< 100 mm2) than in normal-sized aortas (mainly > 3mm and > 100 mm2). Distribution of risk factors was similar in both groups with the highest mean calcium score being present in patients with 4 risk factors. Pearson's correlation coefficient indicating correlation between total calcium score and number of risk factors was almost the same in both groups: AAA, r = 0.67; non-AAA, r = 0.65.
Compared to normal-sized aortas thinner and smaller plaques are present in AAA, which may be due to degenerative processes.
多排螺旋计算机断层扫描(MDCT)越来越多地用于评估和量化冠状动脉钙化,但钙化程度与临床事件发生之间的相关性在其他血管床(如主动脉)中也已为人所知。
评估动脉瘤性和非动脉瘤性腹主动脉钙化量和模式的可能差异。
34名受试者表现为肾下腹主动脉瘤(AAA),并使用MDCT与33名主动脉大小正常的患者进行比较。由两名放射科医生进行定量和定性分析。评估整个腹主动脉以及肾上段和肾下段的钙评分。此外,根据斑块的厚度和大小对斑块模式进行评估和分类。此外,钙评分与多种心血管危险因素相关。
有和没有AAA的患者的总钙评分相当(分别为1213±1351和1211±1535),但在斑块密度方面发现了显著差异,非动脉瘤组的肾上段和肾下段的斑块密度均明显更高(AAA:肾上段,0.01;肾下段,0.07;非AAA:肾上段,0.06;肾下段,0.16)。动脉瘤性主动脉肾下段的斑块模式有很大不同:它们比正常大小的主动脉更薄(1和2毫米)且更小(<100平方毫米)(正常大小的主动脉主要>3毫米且>100平方毫米)。两组的危险因素分布相似,4个危险因素的患者平均钙评分最高。两组中表示总钙评分与危险因素数量之间相关性的Pearson相关系数几乎相同:AAA,r = 0.67;非AAA,r = 0.65。
与正常大小的主动脉相比,AAA中存在更薄、更小的斑块,这可能是由于退行性过程所致。