中心线法测量B型主动脉夹层锚定区的初步研究

Centerline analysis for the measurement of aortic diameter at proximal landing zone in type B aortic dissection: a preliminary study

目的评价中心线(CL)测量法作为Stanford B型主动脉夹层锚定区测量验算手段的可行性。方法从中国医科大学附属第一医院主动脉夹层数据库中随机抽取Stanford B型主动脉夹层患者30例(男24例,中位年龄49.5岁)CTA资料,2位血管影像学专家独立采用多平面重建(MPR)测量法及CL测量法采集数据,以混合线性模型分析2种方法测量结果的异同,Bland-Altman法行不同方法、不同测量者之间测量结果的一致性分析。结果 2位测量者用MPR法测得值分别为(29.73±2.99)mm、(29.86±2.95)mm,CL法测得值分别为(29.66±2.81)mm、(29.71±2.91)mm,2种方法所测值比较,差异无统计学意义(P=0.58),但CL测量法更便捷。结论在Stanford B型主动脉夹层锚定区血管直径测量时,CL测量法可作为MPR测量法的验算方法。

Objective To investigate the feasibility of centerline measurement method in estimating aortic diameter at the proximal landing zone in Stanford B type aortic dissection. Methods CT angiography materials of 30 patients with type B aortic dissection were randomly selected from the hospital database （24 males with a median age of 49.5 years）, which were retrospectively analyzed with multiplanar reformation （MPR） and centerline technique by two experts in vascular radiology. Difference between two measurement techniques was analyzed by using mixed linear model, and the agreement of measurements between two readers as well as between two techniques were evaluated by Bland-Ahman plots. Results The diameters measured with MPR method by two experts were （29.73±2.99） mm and （29.86±2.95） mm respectively, while the diameters measured with centerline measurement method by two experts were （29.66±2.81） mm and （29.71±2.91） mm respectively. No statistically significant differences in the diameter value existed between the two measurement methods, although the results determined by centerline measurement method were more stable. Conclusion In determining aortic diameter at the proximal landing zone in Stanford B type aortic dissection, the centerline analysis provides a checking method for MPR measurement.