心电门控CTA评价急性主动脉夹层的临床应用研究

Clinical Application of ECG Gated CTA in Evaluation of Acute Aortic Dissection

目的：本研究通过主动脉CTA与胸痛三联排查扫描（心电门控）CTA主动脉图像质量的比较,明确施加心电门控的CTA在临床选择与评价主动脉夹层治疗方案中的价值。方法：通过影像数据存储与传输系统（PACS）回顾性选取2013年1月至2016年3月间行胸痛三联排查与主动脉CTA的患者62例,分为两组,A组行胸痛三联排查扫描（13例）,B组行主动脉CTA（49例）。评价主动脉图像质量与主动脉夹层各项指标可评估性。计量资料比较采用两独立样本t检验,计数资料比较采用χ~2检验。P〈0.05认为差异具有统计学意义。结果：A组主动脉根部CT值为367.000 HU±28.73 HU,B组主动脉根部CT值为335.24 HU±45.73 HU,t=1.653,P=0.104,差异无统计学意义。A组与B组内膜片、主动脉瓣、冠状动脉形态学可评估性差异具有统计学意义（P〈0.05）。破口位置与数目、主动脉弓分支与真假腔可评估性差异无统计学意义（P〉0.05）。结论：施加心电门控的主动脉CTA较常规螺旋扫描主动脉CTA可以更加清晰地显示主动脉夹层各项指标,在进行疾病预后评估、指导治疗方案与制定手术/血管内治疗计划中具有一定作用。

Objective： In this study, we would compare to the routine aorta CTA and ECG gated aorta CTA image quality, in order to know the advantage of ECG gated aorta CTA in evaluation of aortic dissection. Methods： Through the imaging system retrospectively selected 62 patients who underwent aorta CTA from 2013 January to 2016 March, divided into two groups. Group A underwent triple rule out scanning（13 cases）, group B underwent aortic CTA（49 cases）. Evaluation of aortic image quality and assessment of various indexes of aortic dissection. The measurement data were compared by two independent samples t test, and count data were compared using chi-square test. A（P 0.05） consider the statistical significance difference. Results： Attenuation of aortic root in Group A was 367.000 HU ± 28.73 HU, in Group B was 335.24 HU ± 45.73 HU（t = 1.653, P = 0.104）, the difference was not statistically significant. The position and number of break, the aorta valve morphology, coronary artery morphology of group A and group B can be assessed statistically significant difference（P 0.05）. intima morphology, branches of the aortic arch and true/false lumen could assessment showed no statistical significance（P 0.05）. Conclusions： Applying the ECG gated aortic CTA compared with the conventional spiral aorta CTA, it could clearly display the index of aortic dissection, evaluate prognosis of aortic dissection, guide the therapy and formulate operation /endovascular treatment plan.