Boufi M, Guivier-Curien C, Loundou A D, Deplano V, Boiron O, Chaumoitre K, Gariboldi V, Alimi Y S
Aix-Marseille Université, IFSTTAR, UMR T24, 13916, Marseille, France; APHM, University Hospital Nord, Department of Vascular Surgery, 13915, Marseille, France; Aix-Marseille Université, CNRS, Ecole Centrale Marseille, IRPHE UMR 7342, 13384, Marseille, France.
Aix-Marseille Université, CNRS, Ecole Centrale Marseille, IRPHE UMR 7342, 13384, Marseille, France.
Eur J Vasc Endovasc Surg. 2017 May;53(5):663-670. doi: 10.1016/j.ejvs.2017.02.023. Epub 2017 Mar 25.
OBJECTIVE/BACKGROUND: This study aimed to describe an arch morphology protocol in a healthy population, and to assess the impact of age and sex.
A retrospective morphology evaluation was conducted in a population with no personal history of thoracic aorta surgery or pathology, through computed tomography (CT) imaging analysis, using a standardised protocol. Based on centreline three dimensional coordinates, a single investigator calculated a series of parameters in the arch zones and in the total arch, using Matlab scripts. These were categorized as: (i) morphometric data: diameter, length and aortic angle of each zone, total arch angle, and length; (ii) geometric data: tortuosity index (TI), arch width, assimilated curvature radius (CR), and attachment zone angles. Student or Mann-Whitney tests were used to compare parameter means. Their variability with age and sex was assessed through univariate and multivariate regression analysis.
CT images from 123 subjects (mean ± SD age 53 ± 19 years) were reviewed. Significant correlation between age and morphology was found. The aorta expanded homogeneously and stretched heterogeneously with age because of posterior arch elongation. TI decrease, CR, and attachment zone angle increase were also observed with aging. Age remained significantly associated with these morphological parameters, independently of body surface area and hypertension. Sex also affected morphology: longer total arch length and higher CR in men; lower zone 3 attachment angle in women CONCLUSION: Using mathematical algorithms, and with a view to improving endovascular arch treatment, this study provides a standardised arch morphology protocol and objectively identifies both age related evolution and sex related variation in the different zones.
目的/背景：本研究旨在描述健康人群的主动脉弓形态学方案，并评估年龄和性别的影响。
通过计算机断层扫描（CT）成像分析，采用标准化方案，对无胸主动脉手术或病理个人史的人群进行回顾性形态学评估。基于中心线三维坐标，一名研究人员使用Matlab脚本计算主动脉弓区域和整个主动脉弓的一系列参数。这些参数分为：（i）形态测量数据：每个区域的直径、长度和主动脉角、整个主动脉弓角和长度；（ii）几何数据：弯曲指数（TI）、主动脉弓宽度、等效曲率半径（CR）和附着区角度。采用学生检验或曼-惠特尼检验比较参数均值。通过单变量和多变量回归分析评估其随年龄和性别的变异性。
回顾了123名受试者（平均±标准差年龄53±19岁）的CT图像。发现年龄与形态学之间存在显著相关性。随着年龄增长，主动脉均匀扩张但不均匀伸展，原因是后弓伸长。随着年龄增长，还观察到TI降低、CR增加和附着区角度增加。年龄与这些形态学参数仍显著相关，独立于体表面积和高血压。性别也影响形态学：男性的整个主动脉弓长度更长，CR更高；女性的3区附着角更低。结论：本研究使用数学算法，旨在改善血管内主动脉弓治疗，提供了标准化的主动脉弓形态学方案，并客观地识别了不同区域与年龄相关的演变和与性别相关的差异。
