Orabi Norman A, Quint Leslie E, Watcharotone Kuanwong, Nan Bin, Williams David M, Kim Karen M
University of Michigan Medical School, Ann Arbor, USA.
Department of Radiology, Michigan Medicine, Ann Arbor, USA.
Int J Cardiovasc Imaging. 2018 Nov;34(11):1831-1840. doi: 10.1007/s10554-018-1398-x. Epub 2018 Jun 18.
The aim was to compare computed tomography (CT) features in acute and chronic aortic dissections (AADs and CADs) and determine if a certain combination of imaging features was reliably predictive of the acute versus chronic nature of disease in individual patients. Consecutive patients with aortic dissection and a chest CT scan were identified, and 120 CT scans corresponding to 105 patients were reviewed for a variety of imaging features. Statistical tests assessed for differences in the frequency of these features. A predictive model was created and tested on an additional 120 CT scans from 115 patients. Statistically significant features of AAD included periaortic confluent soft tissue opacity, curved dissection flap, and highly mobile dissection flap, and features of CAD included thick dissection flap, false lumen (FL) outer wall calcification, FL thrombus, dilated FL, and tear edges curling into the FL. The model predicted the chronicity of a dissection with an area under the curve of 0.98 (CI 0.98-1.00). AADs and CADs demonstrated significantly different CT imaging features.
目的是比较急性和慢性主动脉夹层（AAD和CAD）的计算机断层扫描（CT）特征，并确定某些成像特征组合是否能可靠预测个体患者疾病的急性或慢性性质。识别出连续的主动脉夹层患者并进行胸部CT扫描，对对应105例患者的120份CT扫描进行了多种成像特征的评估。统计检验评估了这些特征出现频率的差异。建立了一个预测模型，并在来自115例患者的另外120份CT扫描上进行了测试。AAD的统计学显著特征包括主动脉周围融合性软组织密度影、弯曲的夹层瓣和高度可移动的夹层瓣，而CAD的特征包括增厚的夹层瓣、假腔（FL）外壁钙化、FL血栓形成、FL扩张以及撕裂边缘向FL卷曲。该模型预测夹层慢性程度的曲线下面积为0.98（CI 0.98 - 1.00）。AAD和CAD表现出明显不同的CT成像特征。
