DebakeyⅠ型与Ⅲ B型主动脉夹层真假腔判别的定量分析

Discrimination of True and False Lumen in Dissection of Aorta for Debakey Ⅰ and Ⅲ B Patients:A Quantitative Analysis

目的：本研究通过对主动脉夹层真假腔绝对面积、相对面积与平均衰减值的测量和分析明确其在判别真假腔中的应用价值。方法：回顾性分析2011年5月～2013年11月因急性胸痛就诊的可疑主动脉夹层患者65例，中位年龄54岁，其中男性49例，女性16例，符合纳入标准与排除标准。所选患者均进行标准主动脉CTA检查。测量多平面数据，测量指标包括真假腔绝对面积（并通过计算得出相对面积）和平均衰减值。比较真假腔绝对面积、相对面积以及其平均衰减值。绘制ROC曲线求出真假腔绝对面积、相对面积与平均衰减值判别真假腔的曲线下面积。结果：平均真腔绝对面积为（656．30±386．21）mm^2，平均假腔绝对面积为（951．21±464．32）mm^2，经配对样本t检验，t=-49．318，P=0．000，差异具有统计学意义；平均真腔相对面积为0．33±0．14，平均假腔相对面积为0．67±0．14，经配对样本t检验，t=-34．235，P=0．000，差异具有统计学意义；平均真腔衰减值为（234．02±83．53）Hu，平均假腔衰减值为（238．54±87．40）Hu，经配对样本t检验，t=-0．914，P=0．361，差异无统计学意义；真假腔绝对面积、相对面积与平均衰减值ROC曲线示曲线下面积分别为0．846、0．950与0．525，P值为0．000、0．000、0．092。结论：通过相对面积进行真假腔识别具有极高的灵敏度与特异度，同时结合影像学征象可以准确判别。

Objective： The purpose of this study based on the measurement and analysis of absolute area, relative area and the average attenuation for true and false lumen in aortic dissection for distinguishing. Methods： A retrospective analysis of May 2011, to November 2013 with acute chest pain of 65 cases of suspected aortic dissection patients, the median age was 54 years, 49 cases of men and 16 cases of women. Comply with the inclusion criteria and exclusion criteria. The patients were selected for standard aorta CTA. The graphic indicators was measured by absolute area （and calculated relative area）, the average attenuation for true and false lumen. Compare the absolute area, relative area and attenuation of true and false lumen. The absolute area, relative area and attenuation of AUC were calculated by ROC. Results： The average absolute area of true lumen was （656.30±386.21） mm^2, the average absolute area of false lumen was （951.21 ±464.32） mm^2, by paired sample t test, t = 49.318, P = 0.000, the difference was statistically significant; The Average relative area of true lumen was 0.33±0.14, The Average relative area of false lumen was 0.67±0.14, by paired sample t test, t=34.235, P = 0.000, the difference was statistically significant; Average true lumen attenuation value was （234.02 ±83.53） Hu, false lumen attenuation value was （238.54 ± 87.40） Hu, by paired sample t test, t = 0.914, P = 0.361, there was no statistically significant difference; the absolute area, relative area and the attenuation of AUC was 0.846, 0.950 and 0.525, P value was 0.000, 0.000, and 0.092, respectively. Conclusion： The relative area had high sensitivity and specificity that was used to identify the true and false lumen.