Department of Medicine, Gyeongsang National University College of Medicine, 816-15 Jinju-daero, Jinju 52727, Republic of Korea.
Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Republic of Korea.
Medicina (Kaunas). 2023 Jun 19;59(6):1172. doi: 10.3390/medicina59061172.
: Vascular abnormalities within the anatomical coverage are frequently encountered in imaging studies. The aortic arch is often overlooked as an anatomical blind spot, especially in neck magnetic resonance (MR) angiography. This study investigated the prevalence of incidental aortic arch abnormalities. We also estimated the potential clinical significance of aortic arch abnormalities as blind spots detected on contrast-enhanced neck MR angiography. : Between February 2016 and March 2023, 348 patients were identified based on contrast-enhanced neck MR angiography reports. The clinical and radiological characteristics of the patients and the presence of additional imaging studies were assessed. The aortic arch abnormalities and coexisting non-aortic arterial abnormalities were classified into two categories according to their clinical significance. We performed the χ test and Fisher's exact test for group comparisons. : Of the 348 study patients, only 29 (8.3%) had clinically significant incidental aortic arch abnormalities. Among these 348 patients, 250 (71.8%) and 136 (39%) had intracranial and extracranial abnormalities, respectively; the clinically significant intracranial abnormalities in the two groups were 130 lesions (52.0%) and 38 lesions (27.9%), respectively. In addition, there was a significantly higher tendency of clinically significant aortic arch abnormalities (13/29, 44.8%) in the patients who had clinically significant coexisting non-aortic arterial abnormalities than in the other group (87/319, 27.3%) ( = 0.044). The patient groups with clinically significant intracranial or extracranial arterial abnormalities had higher rates of clinically significant aortic abnormalities (31.0% and 17.2%), but there was no statistical significance ( = 0.136). : The incidence of clinically significant aortic arch abnormalities was 8.3% on neck MR angiography, with a significant association between aortic and coexisting non-aortic arterial abnormalities. The findings of this study could improve the understanding of incidental aortic arch lesions on neck MR angiography, which is of crucial clinical importance for radiologists to achieve accurate diagnoses and management.
在影像学研究中，经常会遇到解剖覆盖范围内的血管异常。主动脉弓通常被视为解剖学上的盲点，尤其是在颈部磁共振（MR）血管造影中。本研究旨在调查偶然发现的主动脉弓异常的发生率。我们还估计了在增强颈部 MR 血管造影中作为盲点检测到的主动脉弓异常的潜在临床意义。
在 2016 年 2 月至 2023 年 3 月期间，根据增强颈部 MR 血管造影报告确定了 348 名患者。评估了患者的临床和放射学特征以及是否进行了其他影像学研究。根据其临床意义，将主动脉弓异常和并存的非主动脉动脉异常分为两类。我们对组间进行了 χ检验和 Fisher 确切检验。
在 348 名研究患者中，只有 29 名（8.3%）存在偶然的有临床意义的主动脉弓异常。在这 348 名患者中，分别有 250 名（71.8%）和 136 名（39%）患者存在颅内和颅外异常；两组中具有临床意义的颅内异常分别为 130 个病变（52.0%）和 38 个病变（27.9%）。此外，在有临床意义的并存非主动脉动脉异常的患者中，有临床意义的主动脉弓异常（13/29，44.8%）的倾向明显高于另一组（87/319，27.3%）（ = 0.044）。在有临床意义的颅内或颅外动脉异常的患者组中，具有临床意义的主动脉异常的发生率更高（31.0%和 17.2%），但无统计学意义（ = 0.136）。
在颈部 MR 血管造影中，有临床意义的主动脉弓异常的发生率为 8.3%，主动脉弓与并存的非主动脉动脉异常之间存在显著关联。本研究的结果可以提高对颈部 MR 血管造影中偶然发现的主动脉弓病变的认识，这对放射科医生实现准确诊断和管理具有重要的临床意义。
