Department of Radiology, Shanxi Bethune Hospital, No. 99, Longcheng Street, Taiyuan, 030036, Shanxi, China.
Department of Emergency, Shanxi Bethune Hospital, Taiyuan, 030036, Shanxi, China.
Abdom Radiol (NY). 2024 Dec;49(12):4334-4340. doi: 10.1007/s00261-024-04312-w. Epub 2024 Aug 1.
The aim of this study was to investigate the clinical and multi-slice spiral computed tomography angiography (MSCTA) characteristics for the diagnosis of infected AAA.
This retrospective comparative study included patients who were diagnosed with AAA at our hospital between January 2014 and May 2023.
A total of 40 patients were included, comprising 20 with infected AAA and 20 with non-infected AAA. Patients with infected AAA were more likely to be younger (62.9 ± 10.1 vs. 70.0 ± 4.4 years, P = 0.007) and to present with fever [7 (35%) vs. 1 (5%), P = 0.026], pain [15 (75%) vs. 2 (10%), P < 0.001], higher C-reactive protein levels (60.4 ± 57.0 vs. 4.1 ± 2.9 mg/l, P = 0.005), and higher erythrocyte sedimentation rates (47.7 ± 23.4 vs. 15.2 ± 8.3 mm/h, P < 0.001) compared to those with non-infected AAA. Moreover, those with infected AAA exhibited significantly more eccentric saccular morphology [17 (85%) vs. 1 (5%), P = 0.002], a smaller longitudinal-transverse ratio (1.12 ± 0.33 vs. 2.33 ± 0.54, P = 0.001), thicker peri-aneurysmal soft tissue (2.29 ± 1.48 vs. 0.73 ± 0.55 cm, P < 0.001), more lobulated margins [18 (90%) vs. 1 (5%), P = 0.001], lower aortic calcification scores (49 vs. 56, P < 0.001), more pneumatosis [6 (30%) vs. 0 (0%), P = 0.014], more ruptures [15 (75%) vs. 5 (20%), P = 0.002], more blurred peri-abdominal aortic fat spaces [16 (80%) vs. 2 (10%), P = 0.001], more adjacent bone destruction [5 (25%) vs. 0 (0%), P = 0.025], more involvement of the psoas major muscle [8 (40%) vs. 1 (5%), P = 0.005], more lymphadenectasis [8 (40%) vs. 1 (5%), P = 0.020], and less tortuous aortas [2 (10%) vs. 9 (45%), P = 0.034] compared with those with non-infected AAA.
The clinical manifestations and MSCTA characteristics may differ between infected and non-infected AAA.
本研究旨在探讨感染性腹主动脉瘤（AAA）的临床和多层螺旋 CT 血管造影（MSCTA）特征。
本回顾性对比研究纳入了 2014 年 1 月至 2023 年 5 月期间在我院诊断为 AAA 的患者。
共纳入 40 例患者，其中 20 例为感染性 AAA，20 例为非感染性 AAA。感染性 AAA 患者更年轻（62.9±10.1 岁 vs. 70.0±4.4 岁，P=0.007），更易出现发热[7（35%） vs. 1（5%），P=0.026]、疼痛[15（75%） vs. 2（10%），P<0.001]、更高的 C 反应蛋白水平（60.4±57.0 比 4.1±2.9mg/l，P=0.005）和红细胞沉降率（47.7±23.4 比 15.2±8.3mm/h，P<0.001），而非感染性 AAA 患者。此外，感染性 AAA 患者的囊状形态更偏心[17（85%） vs. 1（5%），P=0.002]，纵向-横向比更小（1.12±0.33 比 2.33±0.54，P=0.001），更厚的瘤周软组织[2.29±1.48 比 0.73±0.55cm，P<0.001]，更分叶状边缘[18（90%） vs. 1（5%），P=0.001]，更低的主动脉钙化评分（49 比 56，P<0.001），更多的积气[6（30%） vs. 0（0%），P=0.014]，更多的破裂[15（75%） vs. 5（20%），P=0.002]，更模糊的腹腔主动脉脂肪间隙[16（80%） vs. 2（10%），P=0.001]，更多的邻近骨破坏[5（25%） vs. 0（0%），P=0.025]，更大的腰大肌受累[8（40%） vs. 1（5%），P=0.005]，更多的淋巴结肿大[8（40%） vs. 1（5%），P=0.020]，更少的主动脉迂曲[2（10%） vs. 9（45%），P=0.034]。
感染性和非感染性 AAA 的临床表现和 MSCTA 特征可能不同。
