Kontopodis Nikolaos, Metaxa Eleni, Papaharilaou Yannis, Georgakarakos Efstratios, Tsetis Dimitris, Ioannou Christos V
Department of Vascular Surgery, University of Crete Medical School, Heraklion, Greece.
Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete, Greece.
Eur J Radiol. 2014 Jul;83(7):1051-1056. doi: 10.1016/j.ejrad.2014.03.018. Epub 2014 Apr 2.
To examine whether indices other than the traditionally used abdominal aortic aneurysm (AAA) maximum diameter, such as AAA volume, intraluminal thrombus (ILT) thickness and ILT volume, may be superior to evaluate aneurismal enlargement.
Thirty-four small AAAs (initially presenting a maximum diameter <5.5cm which is the threshold for surgical repair) with an initial and a follow-up CT were examined. Median increase and percentile annual change of these variables was calculated. Correlation between growth rates as determined by the new indices under evaluation and those of maximum diameter were assessed. AAAs were divided according to outcome (surveillance vs. elective repair after follow-up which is based on the maximum diameter criterion) and according to growth rate (high vs. low) based on four indices. Contingency between groups of high/low growth rate regarding each of the four indices on one hand and those regarding need for surgical repair on the other was assessed.
A strong correlation between growth rates of maximum diameter and those of AAA and ILT volumes could be established. Evaluation of contingency between groups of outcome and those of growth rate revealed significant associations only for AAA and ILT volumes. Subsequently AAAs with a rapid volumetric increase over time had a likelihood ratio of 10 to be operated compared to those with a slower enlargement. Regarding increase of maximum diameter, likelihood ratio between AAAs with rapid and those with slow expansion was only 3.
Growth rate of aneurysms regarding 3Dimensional indices of AAA and ILT volumes is significantly associated with the need for surgical intervention while the same does not hold for growth rates determined by 2Dimensional indices of maximum diameter and ILT thickness.
研究除传统使用的腹主动脉瘤（AAA）最大直径外的其他指标，如AAA体积、腔内血栓（ILT）厚度和ILT体积，在评估动脉瘤扩大方面是否更具优势。
对34例小型AAA（初始最大直径<5.5cm，这是手术修复的阈值）进行了初次和随访CT检查。计算这些变量的中位数增加量和年度百分变化。评估所评估的新指标确定的生长率与最大直径生长率之间的相关性。根据结果（随访后的监测与基于最大直径标准的择期修复）和基于四个指标的生长率（高与低）对AAA进行分类。评估一方面关于四个指标中每个指标的高/低生长率组与另一方面关于手术修复需求的组之间的列联情况。
可以确定最大直径生长率与AAA和ILT体积生长率之间存在强相关性。对结果组和生长率组之间的列联情况进行评估后发现，仅AAA和ILT体积存在显著关联。随后，随着时间推移体积快速增加的AAA与扩张较慢的AAA相比，手术的似然比为10。关于最大直径的增加，快速扩张和缓慢扩张的AAA之间的似然比仅为3。
AAA和ILT体积的三维指标所反映的动脉瘤生长率与手术干预需求显著相关，而由最大直径和ILT厚度的二维指标确定的生长率则不然。
