Academic Surgery Unit, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester, UK.
Academic Surgery Unit, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester, UK.
Ann Vasc Surg. 2022 Nov;87:469-477. doi: 10.1016/j.avsg.2022.05.017. Epub 2022 Jun 3.
Abdominal aortic aneurysms (AAAs) are increasingly screen-detected and many small aneurysms enter surveillance. Computed tomography identifies characteristics that can predict subsequent AAA growth but ionizing radiation and nephrotoxic contrast disadvantage its use in surveillance. We investigated whether duplex and 3-dimensional tomographic ultrasound identified features associated with AAA growth in patients on AAA surveillance.
Duplex and three-dimensional tomographic ultrasound imaging was performed independently by 2 vascular scientists in 128 AAA surveillance patients who all had AAA growth measured over at least 2 years. Diameter, cross-sectional area, length, volume, wall thickness/volume, and intraluminal thrombus were measured. Pulsatility using maximum systolic and minimum diastolic diameters corrected for diameter and distensibility (consisting of strain and stiffness) were also calculated.
AAA growth rate correlated with AAA diameter (r 0.43), volume (r 0.46), and cross-sectional area (r 0.42) (P < 0.01). Measuring wall thickness was inaccurate, but wall volume (corrected for AAA volume) inversely related to growth rate (r -0.43, P < 0.01). On a multivariate analysis, diameter and wall volume (r 0.22, P < 0.01) improved prediction of growth rate compared with diameter alone (r 0.18, P < 0.01). Intraluminal thrombus volume, strain distensibility, and elastic distensibility were not significantly associated with AAA growth.
AAA growth most strongly related to AAA volume and inversely to wall volume. AAA volume and wall volume may prove useful in the prediction of AAA growth rates.
腹主动脉瘤（AAA）的检出率越来越高，许多小动脉瘤进入监测阶段。计算机断层扫描（CT）可以识别出一些可以预测AAA 后续生长的特征，但电离辐射和肾毒性造影剂使其在监测中应用受限。我们研究了在 AAA 监测患者中，双功能超声和三维断层超声是否可以识别与 AAA 生长相关的特征。
128 名接受 AAA 监测的患者均进行了至少 2 年的 AAA 生长测量，由 2 名血管科学家独立进行双功能超声和三维断层超声成像。测量了直径、横截面积、长度、体积、壁厚/体积和管腔内血栓。还计算了使用最大收缩期和最小舒张期直径校正直径和可扩张性（由应变和硬度组成）后的脉动。
AAA 生长速率与 AAA 直径（r 0.43）、体积（r 0.46）和横截面积（r 0.42）（P < 0.01）相关。壁厚测量不准确，但壁厚体积（校正 AAA 体积后）与生长速率呈负相关（r -0.43，P < 0.01）。多元分析显示，与仅测量直径相比，直径和壁厚体积（r 0.22，P < 0.01）可更好地预测生长速率（r 0.18，P < 0.01）。管腔内血栓体积、应变可扩张性和弹性可扩张性与 AAA 生长无显著相关性。
AAA 生长与 AAA 体积最密切相关，与壁厚体积呈反比。AAA 体积和壁厚体积可能有助于预测 AAA 生长速率。
