Sailer Anna M, Wagemans Bart A J M, Das Marco, de Haan Michiel W, Nelemans Patricia J, Wildberger Joachim E, Schurink Geert Willem H
Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands
Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
J Endovasc Ther. 2015 Dec;22(6):905-11. doi: 10.1177/1526602815605325. Epub 2015 Sep 17.
To assess and quantify the magnitude and direction of respiratory movement of the aorta and origins of its side branches.
A quantitative 3-dimensional (3D) subtraction analysis of computed tomography (CT) scans during inspiration and expiration was performed to determine the respiratory geometric movements of the aorta and side branches in 60 patients. During breath-hold expiration and inspiration, 1-mm-thick CT slices of the aorta were acquired in unenhanced and contrast-enhanced scans. The datasets were compared using dedicated multiplanar reformation image subtraction software to determine the change in position of relevant anatomic sections, including the ascending thoracic aorta (AA), the origins of the brachiocephalic artery (BA) and left subclavian artery (LSA), the descending thoracic aorta (DTA) at the level of the tenth thoracic vertebra, as well as the origins of the celiac trunk, superior mesenteric artery, and the renal arteries.
Complex movement was visible during inspiration; the regions of interest in the thoracic aorta and side branches moved in the anterior, medial, and caudal directions compared with the expiration state. Mean 3D movement vectors (± standard deviation) were 8.9±3.6 mm (AA), 12.0±4.1 mm (BA), 11.1±3.9 mm (LSA), and 4.9±2.5 mm (DTA). Abdominal side branches moved in the caudal direction 1.3±1.1 mm. There was significantly less movement in the DTA compared to AA (p<0.001). The correlation coefficient between the extent of LSA movement and thoracic excursion was 0.78.
The aorta and side branches undergo considerable respiratory movement. The results from this study provide an important contribution to understanding aortic dynamics.
评估并量化主动脉及其分支起始处呼吸运动的幅度和方向。
对60例患者在吸气和呼气时的计算机断层扫描（CT）进行定量三维（3D）减法分析，以确定主动脉及其分支的呼吸几何运动。在屏气呼气和吸气过程中，在未增强和增强扫描中获取1毫米厚的主动脉CT切片。使用专用的多平面重建图像减法软件比较数据集，以确定相关解剖部位的位置变化，包括胸主动脉升部（AA）、头臂动脉（BA）和左锁骨下动脉（LSA）的起始处、第十胸椎水平的胸主动脉降部（DTA），以及腹腔干、肠系膜上动脉和肾动脉的起始处。
吸气时可见复杂运动；与呼气状态相比，胸主动脉及其分支的感兴趣区域向前、内侧和尾侧移动。平均三维运动向量（±标准差）分别为8.9±3.6毫米（AA）、12.0±4.1毫米（BA）、11.1±3.9毫米（LSA）和4.9±2.5毫米（DTA）。腹部分支向尾侧移动1.3±1.1毫米。与AA相比，DTA的运动明显较少（p<0.001）。LSA运动程度与胸廓运动之间的相关系数为0.78。
主动脉及其分支经历相当大的呼吸运动。本研究结果为理解主动脉动力学做出了重要贡献。
