评估支架型人工血管治疗后斯坦福B型主动脉夹层患者主动脉重塑时直径变化与容积变化的比较。
Comparison of diametric and volumetric changes in Stanford type B aortic dissection patients in assessing aortic remodeling post-stent graft treatment.
作者信息
Wan Ab Naim Wan Naimah, Sun Zhonghua, Liew Yih Miin, Chan Bee Ting, Jansen Shirley, Lei Jing, Ganesan Poo Balan, Hashim Shahrul Amry, Sridhar Ganiga Srinivasaiah, Lim Einly
机构信息
Faculty of Mechanical and Automotive Engineering Technology, University Malaysia Pahang, 26600, Pekan, Pahang, Malaysia.
Discipline of Medical Radiation Science, Curtin University, Perth 6845, Australia.
出版信息
Quant Imaging Med Surg. 2021 May;11(5):1723-1736. doi: 10.21037/qims-20-814.
BACKGROUND
The study aims to analyze the correlation between the maximal diameter (both axial and orthogonal) and volume changes in the true (TL) and false lumens (FL) after stent-grafting for Stanford type B aortic dissection.
METHOD
Computed tomography angiography was performed on 13 type B aortic dissection patients before and after procedure, and at 6 and 12 months follow-up. The lumens were divided into three regions: the stented area (Region 1), distal to the stent graft to the celiac artery (Region 2), and between the celiac artery and the iliac bifurcation (Region 3). Changes in aortic morphology were quantified by the increase or decrease of diametric and volumetric percentages from baseline measurements.
RESULTS
At Region 1, the TL diameter and volume increased (pre-treatment: volume =51.4±41.9 mL, maximal axial diameter =22.4±6.8 mm, maximal orthogonal diameter =21.6±7.2 mm; follow-up: volume =130.7±69.2 mL, maximal axial diameter =40.1±8.1 mm, maximal orthogonal diameter =31.9+2.6 mm, P<0.05 for all comparisons), while FL decreased (pre-treatment: volume =129.6±150.5 mL; maximal axial diameter =43.0±15.8 mm; maximal orthogonal diameter =28.3±12.6 mm; follow-up: volume =66.6±95.0 mL, maximal axial diameter =24.5±19.9 mm, maximal orthogonal diameter =16.9±13.7, P<0.05 for all comparisons). Due to the uniformity in size throughout the vessel, high concordance was observed between diametric and volumetric measurements in the stented region with 93% and 92% between maximal axial diameter and volume for the true/false lumens, and 90% and 92% between maximal orthogonal diameter and volume for the true/false lumens. Large discrepancies were observed between the different measurement methods at regions distal to the stent graft, with up to 46% differences between maximal orthogonal diameter and volume.
CONCLUSIONS
Volume measurement was shown to be a much more sensitive indicator in identifying lumen expansion/shrinkage at the distal stented region.
背景
本研究旨在分析B型主动脉夹层支架植入术后真腔（TL）和假腔（FL）的最大直径（轴向和正交）与体积变化之间的相关性。
方法
对13例B型主动脉夹层患者在术前、术后以及随访6个月和12个月时进行计算机断层血管造影。管腔分为三个区域：支架置入区域（区域1）、支架移植物远端至腹腔动脉之间的区域（区域2）以及腹腔动脉与髂总动脉分叉之间的区域（区域3）。通过与基线测量相比直径和体积百分比的增加或减少来量化主动脉形态的变化。
结果
在区域1，真腔直径和体积增加（治疗前：体积=51.4±41.9 mL，最大轴向直径=22.4±6.8 mm，最大正交直径=21.6±7.2 mm；随访：体积=130.7±69.2 mL，最大轴向直径=40.1±8.1 mm，最大正交直径=31.9+2.6 mm，所有比较P<0.05），而假腔减小（治疗前：体积=129.6±150.5 mL；最大轴向直径=43.0±15.8 mm；最大正交直径=28.3±12.6 mm；随访：体积=66.6±95.0 mL，最大轴向直径=24.5±19.9 mm，最大正交直径=16.9±13.7，所有比较P<0.05）。由于整个血管大小均匀，在支架置入区域直径和体积测量之间观察到高度一致性，真腔/假腔的最大轴向直径与体积之间分别为93%和92%，真腔/假腔的最大正交直径与体积之间分别为90%和92%。在支架移植物远端区域，不同测量方法之间观察到较大差异，最大正交直径与体积之间差异高达46%。
结论
体积测量在识别支架置入远端区域管腔扩张/缩小方面是一个更为敏感的指标。
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