Patterson Benjamin Oliver, Vidal-Diez Alberto, Karthikesalingam Alan, Holt Peter J E, Loftus Ian M, Thompson Matt M
St George's Vascular Institute, St George's Hospital, London, United Kingdom.
St George's Vascular Institute, St George's Hospital, London, United Kingdom.
Ann Thorac Surg. 2015 Jan;99(1):95-102. doi: 10.1016/j.athoracsur.2014.08.022. Epub 2014 Nov 12.
Different methods have been used to assess remodeling of the thoracic aorta after endovascular treatment of Stanford type B aortic dissections. Changes in morphology may be described using diameter, area, or volume. The aim of this study was to determine if aortic diameter measurements could be used to approximate aortic area in order to refine reporting standards.
The study population encompassed 100 patients enrolled in the VIRTUE registry (designed to assess thoracic endografting with the Valiant Stent Graft System [Medtronic, Minneapolis, MN] for the treatment of type B aortic dissections). Diameter and area measurements of the true lumen, false lumen, and whole aorta were made using three-dimensional computed tomographic (3D CT) workstations, at different anatomic locations. Measurements included preoperative, postoperative, and follow-up scans. The Pearson test was used to determine general correlation between diameter and volume at each location. Scatter plots were drawn and linear regression models were used to draw a line of best fit. Comparison of these with nonlinear models was performed.
Aortic true and false lumen diameter and area showed good correlation (p < 0.001) in the majority of anatomic locations. This relationship was present preoperatively and during follow-up (p < 0.001). The linear regression models fit well with high R(2) values. At very large aortic sizes nonlinear models were a slightly better fit, but this was not significant.
Aortic diameter measurements correlate with luminal areas in patients with type B aortic dissection. This implies area increases proportionately with diameter over time. Therefore, diameter measurements using multiplanar reconstructions based on a central luminal line appear to be adequate when assessing aortic remodeling after endovascular treatment of aortic dissection.
在对Stanford B型主动脉夹层进行血管腔内治疗后，已采用不同方法评估胸主动脉重塑情况。形态学变化可用直径、面积或体积来描述。本研究的目的是确定主动脉直径测量是否可用于估算主动脉面积，以完善报告标准。
研究人群包括100名纳入VIRTUE注册研究的患者（该研究旨在评估使用Valiant支架移植物系统[美敦力公司，明尼阿波利斯，明尼苏达州]进行胸主动脉腔内修复治疗B型主动脉夹层）。使用三维计算机断层扫描（3D CT）工作站在不同解剖位置对真腔、假腔和整个主动脉进行直径和面积测量。测量包括术前、术后及随访扫描。采用Pearson检验确定各位置直径与体积之间的总体相关性。绘制散点图并使用线性回归模型绘制最佳拟合线。将这些结果与非线性模型进行比较。
在大多数解剖位置，主动脉真腔和假腔的直径与面积显示出良好的相关性（p < 0.001）。这种关系在术前及随访期间均存在（p < 0.001）。线性回归模型拟合良好，R²值较高。在主动脉尺寸非常大时，非线性模型拟合稍好，但差异不显著。
B型主动脉夹层患者的主动脉直径测量与管腔面积相关。这意味着面积随时间与直径成比例增加。因此，在评估主动脉夹层血管腔内治疗后的主动脉重塑时，基于中心管腔线的多平面重建进行直径测量似乎就足够了。
