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心脏磁共振成像评价移植物置换升主动脉对降主动脉弹性性能的影响。

Impact of ascending aorta replacement by graft on elastic properties of descending thoracic aorta evaluated by cardiac magnetic resonance imaging.

机构信息

Department of Cardio-Vascular and Thoracic Surgery, Dijon University Hospital, 14 Rue Gaffarel, 21000, Dijon, France.

Le2i Laboratory, University of Burgundy, Dijon, France.

出版信息

MAGMA. 2020 Oct;33(5):641-647. doi: 10.1007/s10334-020-00829-5. Epub 2020 Jan 31.

Abstract

OBJECTIVE

The aim of our study was to evaluate the impact of aortic root replacement by graft on the elastic properties of the descending thoracic aorta using cardiac magnetic resonance imaging (MRI) and automatic post-processing.

MATERIALS AND METHODS

Nineteen patients were operated for an aortic root aneurysm. Cardiac MRI was performed before and after surgery to measure aortic compliance. Images were acquired on a 1.5 T MRI with a conventional aortic MRI protocol plus one additional kinetic sequence orientated perpendicularly to the aorta at the level of pulmonary trunk. The contours of the ascending and descending aortas were detected automatically for each phase with homemade software.

RESULTS

Mean time between surgical procedure and earliest post-operative MRI was 18.2 ± 7.1 months. There was no significant difference between the pre- and earliest post-operative mean descending aorta areas and no significant modification in descending aortic compliance after aortic root replacement (1.43 ± 0.84 vs 1.37 ± 0.58 mm/mmHg, p = 0.47). Pre- and post-operative systolic and diastolic blood pressure were similar. There was a significant decrease in ascending aortic compliance after surgery (2.52 ± 1.24 vs 0.91 ± 0.52 mm/mmHg; p < 0.0001).

DISCUSSION

The aortic root replacement by graft was not associated with changes in elastic properties of the descending aorta at short term.

CLINICAL REGISTRATION NUMBER

NCT03817008.

摘要

目的

本研究旨在使用心脏磁共振成像(MRI)和自动后处理评估通过移植物进行主动脉根部置换对降主动脉弹性特性的影响。

材料与方法

19 例患者因主动脉根部动脉瘤而行手术治疗。在术前和术后进行心脏 MRI 以测量主动脉顺应性。在 1.5T MRI 上采集图像,使用常规主动脉 MRI 方案加一个额外的沿肺动脉干水平垂直于主动脉的动力学序列。使用自制软件自动检测每个相位的升主动脉和降主动脉轮廓。

结果

手术和最早的术后 MRI 之间的平均时间为 18.2±7.1 个月。主动脉根部置换前后降主动脉的平均面积无显著差异,降主动脉顺应性也无显著改变(1.43±0.84 与 1.37±0.58mm/mmHg,p=0.47)。术前和术后的收缩压和舒张压相似。术后升主动脉顺应性显著下降(2.52±1.24 与 0.91±0.52mm/mmHg;p<0.0001)。

讨论

在短期内,通过移植物进行主动脉根部置换与降主动脉弹性特性的变化无关。

临床试验注册号

NCT03817008。

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