Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Medicine (Baltimore). 2022 Jun 17;101(24):e29539. doi: 10.1097/MD.0000000000029539.
Gastroduodenal artery aneurysms (GDAA) and pancreaticoduodenal artery aneurysms (PDAA) are rare, have high rupture risks, and are located in the arcade between the celiac artery and the superior mesenteric artery. Pancreaticoduodenal artery aneurysms are associated with celiac artery stenosis, and it is hypothesized that these celiac lesions might contribute to the formation of aneurysms. In contrast, a few studies have reported an association between a gastroduodenal artery aneurysm and celiac lesions. This study aimed to investigate the potential differences between patients with gastroduodenal and pancreaticoduodenal artery aneurysms and better understand their pathogenesis.We selected patients with GDAA and PDAA who were admitted to our department between January 2010 and December 2020. Aortic wall volume, aortic wall calcification, and pancreaticoduodenal arcade volume of computed tomography images were calculated semi-manually using Horos 3.3.5.Eight GDAAs and 11 PDAAs were analyzed. Celiac lesions were found in all PDAA patients, with none in GDAA cases. Volumetry demonstrated that aortic wall volume and calcification were more prominent in the GDAA group than in the PDAA group (P = .026 and P = .049, respectively). The pancreaticoduodenal arcade volume was larger in the PDAA group (P = .002).In our study, celiac artery lesions were strongly correlated with PDAA. The volume of the pancreaticoduodenal arcade was larger in the PDAA group, and aortic wall volume and calcification were larger in the GDAA group.
胃十二指肠动脉动脉瘤(GDAA)和胰十二指肠动脉动脉瘤(PDAA)较为罕见,破裂风险较高,且位于腹腔干和肠系膜上动脉之间的弓状结构处。胰十二指肠动脉动脉瘤与腹腔干狭窄相关,据推测这些腹腔干病变可能促成了动脉瘤的形成。相比之下,少数研究报告了胃十二指肠动脉动脉瘤与腹腔干病变之间存在关联。本研究旨在探讨胃十二指肠和胰十二指肠动脉动脉瘤患者之间的潜在差异,以更好地了解其发病机制。
我们选择了 2010 年 1 月至 2020 年 12 月期间因胃十二指肠和胰十二指肠动脉动脉瘤而在我科就诊的患者。使用 Horos 3.3.5 半自动计算 CT 图像的主动脉壁体积、主动脉壁钙化和胰十二指肠弓状结构体积。分析了 8 个 GDAA 和 11 个 PDAA。所有 PDAA 患者均存在腹腔干病变,而 GDAA 患者均无腹腔干病变。容量测定结果显示,GDAA 组的主动脉壁体积和钙化程度明显大于 PDAA 组(P = .026 和 P = .049),PDAA 组的胰十二指肠弓状结构体积较大(P = .002)。
在本研究中,腹腔干病变与 PDAA 密切相关。PDAA 组胰十二指肠弓状结构体积较大,而 GDAA 组主动脉壁体积和钙化程度较大。