Lattu Aada, Kauhanen Petteri, Mennander Ari, Hedman Marja, Laaksonen Mona, Rinta-Kiikka Irina, Skyttä Tanja, Arponen Otso
Department of Radiology, Tampere University Hospital, Tampere, Finland.
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Sci Rep. 2025 Jul 2;15(1):22883. doi: 10.1038/s41598-025-94420-4.
Thoracic aortic dilatations (TADs) are commonly detected incidentally. A TAD may develop into aortic aneurysm and subsequently lead to aortic dissection, a highly lethal condition. Earlier detection of TADs could improve the surveillance and surgical management of aneurysms, potentially reducing aortic ruptures. The opportunistic use of thoracic sectional imaging studies performed for other indications, including breast radiation therapy planning, could be used to detect TADs. However, the frequency of TADs and the clinical risk factors for TADs in females undergoing adjuvant breast radiation therapy remain unknown. We retrospectively collected a consecutive cohort of 861 females with breast cancer who underwent adjuvant radiotherapy planning with computed tomography (CT). Using CT scans, we manually measured thoracic aortic dimensions on the hospital's dedicated picture archiving and communication software (PACS). Following the European Society of Cardiology guidelines, a segment of the aorta was considered dilated when its maximal diameter exceeded 40 mm. Additionally, we collected clinical patient data regarding known risk factors predisposing patients to TADs. Out of 861 patients, 80 (9.3%) had a TAD. Compared to those without any TADs, patients with at least one TAD were older (71.3 ± 9.7 years vs. 62.9 ± 11.7 years; P < .001) and more frequently displayed hypertension (62 [77.5%] vs. 354 [45.3%], P < .001), a history of a TIA or stroke (10 [12.5%] vs. 36 [4.6%], P = .007), and aortic valve insufficiency (10 [12.5%] vs. 51 [6.5%], P = .047). The opportunistic use of radiotherapy planning CT scans allows earlier TAD diagnosis, and a significantly large number of female patients (9.3%) had at least one abnormal thoracic aortic dimension. This finding could indicate a need to consider a systematic screening of TADs in patients undergoing adjuvant radiotherapy.
胸主动脉扩张（TADs）通常是偶然发现的。TAD可能发展为主动脉瘤，随后导致主动脉夹层，这是一种高度致命的疾病。早期发现TADs可以改善动脉瘤的监测和手术管理，有可能减少主动脉破裂。对包括乳腺癌放射治疗计划在内的其他适应症进行的胸部断层成像研究的机会性使用，可用于检测TADs。然而，接受辅助性乳腺癌放射治疗的女性中TADs的发生率以及TADs的临床危险因素仍然未知。我们回顾性收集了连续861例接受计算机断层扫描（CT）辅助放疗计划的乳腺癌女性队列。使用CT扫描，我们在医院专用的图像存档和通信软件（PACS）上手动测量胸主动脉尺寸。按照欧洲心脏病学会指南，当主动脉节段的最大直径超过40mm时，该节段被认为扩张。此外，我们收集了有关使患者易患TADs的已知危险因素的临床患者数据。在861例患者中，80例（9.3%）有TAD。与没有任何TAD的患者相比，至少有一个TAD的患者年龄更大（71.3±9.7岁 vs. 62.9±11.7岁；P<0.001），更频繁地出现高血压（62例[77.5%] vs. 354例[45.3%]，P<0.001）、短暂性脑缺血发作或中风病史（10例[12.5%] vs. 36例[4.6%]，P=0.007）以及主动脉瓣关闭不全（10例[12.5%] vs. 51例[6.5%]，P=0.047）。放疗计划CT扫描的机会性使用允许更早诊断TADs，并且相当多的女性患者（9.3%）至少有一个异常的胸主动脉尺寸。这一发现可能表明需要考虑对接受辅助放疗的患者进行TADs的系统筛查。
Zotero 插件