心脏收缩期和舒张期主动脉直径差异的研究

Aortic lumen diameter changes during systolic and diastolic periods： evaluation with ECG-gated computed tomography

目的评估心脏收缩期和舒张期的主动脉直径并比较其差异。方法采用心电门控64排螺旋CT对纳入的115例患者（男78例，平均年龄55.2±9.4岁；女37例，平均年龄60.1±8.5岁）行扫描检查。共选取4个层面（A：头臂干右侧壁近心端1 mm处；B：左颈总动脉左侧壁远心端1 mm处；C：左锁骨下动脉左侧壁远心端1 mm处；D：左锁骨下动脉左侧壁远心端10 cm处）进行分析。每个层面上分别测量心脏收缩期和舒张期主动脉管腔的最大径和最小径。各层面处以收缩期管腔直径减去舒张期管腔直径所得值为差值，以差值/收缩期管腔直径为差值百分比。统计学方法为配对t检验。结果在心脏收缩期和舒张期间各个层面上主动脉的最大径和最小径均差异有统计学意义（P〈0.001）。各层面最大径差值百分比分别为：A层面1.95%（－2.0%～7.0%）；B层面2.12%（－3.0%～6.0%）；C层面1.88%（－1.0%～8.0%）；D层面2.47%（－3.0%～10.0%）；各层面最小径差值百分比分别为：A层面1.43%（－3.0%～5.0%）；B层面2.67%（－2.0%～11.0%）；C层面1.75%（－14.0%～9.0%）；D层面2.99%（－2.0%～11.0%）。结论在心脏收缩期和舒张期主动脉直径差异有统计学意义，我国人群主动脉直径的波动性可能不同于西方人群。

Objective To characterize the changes in the dimensions during systolic and diastolic periods in the aorta with ECG-gated multi-detector CTA scans. Methods The CT angiograms of 115 patients （78 males, mean age 55.2 ± 9.4 years ; 37 females, mean age 60. 1 ± 8. 5 years ） both in systolic and diastolic periods were obtained on a 64-slice ECG-gated multi-deteetor CT scanner. The diameters were measured at four anatomic levels of the aorta. （ Level A ： 1 mm proximal to the innominate artery ; Level B ： 1 mm distal to the left common carotid artery; Level C：I mm distal to the left subclavian artery; Level D：10 cm distal to the left subclavian artery）. On each level, the maximal and the minimal diameters were measured both in systolic and diastolic periods. Results The paired sample t test results showed a significant difference between the systolic and diastolic diameters in all individual subjects on every level （P 〈0. 001 ）. The mean maximum diameter changes were 1.95% （ range - 2. 0% to 7. 0% ）, 2. 12% （range -3.0% to 6. 0%）,1.88%（range -1.0% to 8. 0% ） and 2. 47% （ range -3.0% to 10.0%）at level A,B,C and D, respectively. The mean minimum diameter changes were 1.43% （range -3.0% to 5.0%）, 2.67% （range -2.0% to 11.0%）, 1.75% （range - 14.0% to 9.0%） and 2.99% （range -2. 0% to 11.0% ）at level A, B, C and D, respectively. Conclusions The differences of the aortic diameters between systolic and diastolic periods are significant. The pulsatility of aorta in Chinese population may be different from published Western literature.