冠状动脉计算机断层扫描血管成像评价胸主动脉不同节段弹性特征及其临床应用价值

Coronary computed tomography angiography for evaluating the elastic characteristics of different segments of the thoracic aorta and its clinical application value

目的探讨冠状动脉计算机断层扫描血管成像(CTA)评估无主动脉疾病患者的胸主动脉不同节段形态和弹性特征及其临床应用价值。方法收集2015年10月至2017年10月于河北北方学院附属第一医院行320排640层容积计算机断层扫描(CT)冠状动脉成像的36名受检者的影像资料及临床资料,按照年龄的不同将其分为﹥50岁组(n=18)和﹤50岁组(n=18)。测量升主动脉(AA)中段、降主动脉(DA)起始部管腔在收缩期及舒张期的最长径、最短径及横截面积,计算收缩期与舒张期各参数的差值及主动脉扩张性(AD)值。结果AA收缩期、舒张期、差值的长径、短径、面积均明显大于DA(P﹤0.01)。AA长径、短径、面积的AD值与DA比较,差异均有统计学意义(P﹤0.05)。﹥50岁组受检者收缩期及舒张期AA的长径、短径、面积均大于﹤50岁组受检者(P﹤0.05),长径差值、长径AD、短径差值、短径AD、面积AD均小于﹤50岁组受检者(P﹤0.05)。﹥50岁组受检者收缩期及舒张期DA的长径、短径、面积均大于﹤50岁组受检者(P﹤0.05),面积AD小于﹤50岁组受检者(P﹤0.05);不同年龄组受检者DA的长径差值、长径AD、短径差值、短径AD、面积差值比较,差异均无统计学意义(P﹥0.05)。结论冠状动脉CTA在无需额外增加辐射剂量和对比剂用量的前提下无创性评估胸主动脉不同节段的形态及弹性特征,为主动脉支架的设计和介入技术的操作提供解剖形态学基础。

Objective To investigate the clinical value of coronary computed tomography angiography(CTA)in evaluating the morphological and elastic characteristics of thoracic aorta segments in patients without aortic disease.Method The imaging data and clinical data of 36 subjects who were to undergo 320 rows of 640-slice volume computed tomography(CT)coronary artery imaging in the First Affiliated Hospital of Hebei North University from October 2015 to October 2017 were collected,they were divided into>50 years old group(n=18)and<50 years old group(n=18)according to different ages.The longest diameter,shortest diameter and cross-sectional area of lumen in the middle part of ascending aorta(AA)and descending aorta(DA)were measured during systolic and diastolic periods,and the difference of parameters between systolic and diastolic periods and the value of artery distensibility(AD)were calculated.Result The length diameter,short diameter and area of AA systolic and diastolic periods were all larger than DA,the differences were significant statistically significant(P<0.01).The AD values of AA long diameter,short diameter and area were compared with DA,and the differences were statistically significant(P<0.05).The length diameter,short diameter and area of systolic and diastolic AA in>50 years old group were greater than those in<50 years old group,and the length diameter difference,long diameter AD,short diameter difference,short diameter AD and area AD were smaller than those in<50 years old group,with statistical significance(P<0.05).The long diameter,short diameter and area of systolic and diastolic DA in>50 years old group were higher than those in<50 group,and the area of AD was lower than those in<50 years old group,with statistical significance(P<0.05).There were no statistically significant differences in the length-diameter difference,length-diameter AD,short-diameter difference,short-diameter AD and area difference of DA among different age groups(P>0.05).Conclusion Coronary CTA can noninvasively assess the morphology and elasticity characteristics of different segments of the thoracic aorta without the need for additional radiation dose and contrast dosage,and provide an anatomical-morphological basis for the design of aortic stents and the operation of interventional techniques.