Qin Jinjie, Ouyang Da, Yan Taocui, Wang Haoru, Guo Kui, Jin Xin, Pan Zhengxia, He Ling
Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Department of Cardiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Front Pediatr. 2023 Jun 27;11:1131025. doi: 10.3389/fped.2023.1131025. eCollection 2023.
To study the differences in computed tomography angiography (CTA) imaging of gothic arches, crenel arches, and romanesque arches in children with Aortic Coarctation (CoA), and to apply computational fluid dynamics (CFD) to study hemodynamic changes in CoA children with gothic arch aorta.
The case data and CTA data of children diagnosed with CoA (95 cases) in our hospital were retrospectively collected, and the morphology of the aortic arch in the children was defined as gothic arch ( = 27), crenel arch ( = 25) and romanesque arch ( = 43). The three groups were compared with D1/AOA, D2/AOA, D3/AOA, D4/AOA, D5/AOA, and AAO-DAO angle, TAO-DAO angle, and aortic arch height to width ratio (A/T). Computational fluid dynamics was applied to assess hemodynamic changes in children with gothic arches.
There were no significant differences between D1/AOA and D2/AOA among gothic arch, crenel arch, and romanesque arch ( > 0.05). The differences in D3/AOA, D4/AOA, and D5/AOA among the three groups were statistically significant ( < 0.05), D4/AOA, D5/AOA of the gothic arch group were smaller than the crenel arch group, and the D3/AOA and D5/AOA of the gothic arch group were smaller than the romanesque arch group ( < 0.05). The difference in AAO-DAO angle among the three groups was statistically significant ( < 0.05), and the AAO-DAO angle of gothic arch was smaller than that of romanesque arch and crenel arch group ( < 0.05). There was no significant difference in the TAO-DAO angle between the three groups ( > 0.05). The difference in A/T values among the three groups was statistically significant ( < 0.05), and the A/T values: gothic arch > romanesque arch > crenel arch ( < 0.05). The CFD calculation of children with gothic arch showed that the pressure drop between the distal stenosis and the descending aorta was 58 mmHg, and the flow rate at the isthmus and descending aorta was high and turbulent.
Gothic aortic arch is common in CoA, it may put adverse effects on the development of the aortic isthmus and descending aorta, and its A/T value and AAO-DAO angle are high. CFD could assess hemodynamic changes in CoA.
研究主动脉缩窄（CoA）患儿中哥特式弓、锯齿状弓和罗马式弓的计算机断层血管造影（CTA）成像差异，并应用计算流体动力学（CFD）研究哥特式主动脉弓CoA患儿的血流动力学变化。
回顾性收集我院诊断为CoA的患儿（95例）的病例资料和CTA数据，将患儿主动脉弓形态分为哥特式弓（n = 27）、锯齿状弓（n = 25）和罗马式弓（n = 43）。比较三组的D1/AOA、D2/AOA、D3/AOA、D4/AOA、D5/AOA、AAO - DAO角、TAO - DAO角和主动脉弓高宽比（A/T）。应用计算流体动力学评估哥特式弓患儿的血流动力学变化。
哥特式弓、锯齿状弓和罗马式弓组的D1/AOA和D2/AOA之间无显著差异（P > 0.05）。三组间D3/AOA、D4/AOA和D5/AOA的差异有统计学意义（P < 0.05），哥特式弓组的D4/AOA、D5/AOA小于锯齿状弓组，哥特式弓组的D3/AOA和D5/AOA小于罗马式弓组（P < 0.05）。三组间AAO - DAO角的差异有统计学意义（P < 0.05），哥特式弓的AAO - DAO角小于罗马式弓组和锯齿状弓组（P < 0.05）。三组间TAO - DAO角无显著差异（P > 0.05）。三组间A/T值的差异有统计学意义（P < 0.05），A/T值：哥特式弓>罗马式弓>锯齿状弓（P < 0.05）。哥特式弓患儿的CFD计算显示，远端狭窄与降主动脉之间的压力降为58 mmHg，峡部和降主动脉处的流速高且紊乱。
哥特式主动脉弓在CoA中常见，可能对主动脉峡部和降主动脉的发育产生不利影响，其A/T值和AAO - DAO角较高。CFD可评估CoA的血流动力学变化。
