Bellala A P, Valakkada J, Ayappan A, Kannath S, Shivanesan P
Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, 695011, Kerala, India.
Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, 695011, Kerala, India.
Clin Radiol. 2024 Apr;79(4):e616-e623. doi: 10.1016/j.crad.2023.12.007. Epub 2023 Dec 27.
To assess the relationship between four-dimensional (4D)-flow-derived false lumen regurgitation fraction (FLRF) and energy loss (EL) percentage in the descending thoracic aorta (DTA) with the aortic growth rate in uncomplicated type B aortic dissection (uTBAD).
In this prospective study performed on 15 patients with uTBAD, computed tomography (CT) angiography and 4D-flow magnetic resonance imaging (MRI) were performed at the initial presentation with follow-up CT at 2 years. 4D-flow parameters, including maximum peak systolic velocity (PSV), FLRF, and percentage of EL were measured using Circle CV42. The significance of these parameters for expansion (>3 mm/year) of aortic dissection was analysed.
Five patients had an enlarging aorta, while 10 had a stable aortic size. The Mann-Whitney U-test showed entry tear >10 mm (p=0.026), FLRF (7.6 ± 8.9 versus 64.8 ± 16.7%; p=0.002), EL in the DTA in (1.61 ± 1.99 versus 2.21 ± 0.32 μW/cm; p=0.014) and percentage of EL in the DTA to overall energy loss from the ascending aorta to the DTA (37 ± 15% versus 66 ± 17%; p=0.005), having a statistically significant different expanding stable dissection. A positive significant Spearman correlation was noted with the aortic growth rate (in millimetres over 2 years) with FLRF (r=0.71, p=0.003), EL in the DTA (r=0.56, p=0.007), and percentage of EL in the DTA (r=0.62, p=0.003).
4D flow parameters, including FLRF and the percentage amount of EL in the DTA may help predict aortic growth at an early stage in uTBAD.
评估在单纯B型主动脉夹层（uTBAD）中，降主动脉（DTA）的四维（4D）血流衍生的假腔反流分数（FLRF）和能量损失（EL）百分比与主动脉生长速率之间的关系。
在这项对15例uTBAD患者进行的前瞻性研究中，在初次就诊时进行计算机断层扫描（CT）血管造影和4D血流磁共振成像（MRI），并在2年时进行随访CT检查。使用Circle CV42测量4D血流参数，包括最大收缩期峰值速度（PSV）、FLRF和EL百分比。分析这些参数对主动脉夹层扩张（>3 mm/年）的意义。
5例患者主动脉增大，10例患者主动脉大小稳定。Mann-Whitney U检验显示入口撕裂>10 mm（p=0.026）、FLRF（7.6±8.9%对64.8±16.7%；p=0.002）、DTA中的EL（1.61±1.99对2.21±0.32 μW/cm；p=0.014）以及DTA中EL占从升主动脉到DTA总能量损失的百分比（37±15%对66±17%；p=0.005），在扩张性稳定夹层中有统计学显著差异。观察到主动脉生长速率（2年内的毫米数）与FLRF（r=0.71，p=0.003）、DTA中的EL（r=0.56，p=0.007）以及DTA中EL百分比（r=0.62，p=0.003）之间存在显著的正Spearman相关性。
4D血流参数，包括FLRF和DTA中的EL百分比，可能有助于在uTBAD早期预测主动脉生长。
