正常主动脉弓的形态特点

Morphological features of normal aortic arch

目的通过CT血管造影(CTA)方式回顾性分析天津地区人群正常主动脉弓的形态学特点。方法选择2016年1月—12月在我院接受胸主动脉CTA检查的患者142例,使用GE公司AW4.6工作站测量弓上分支的直径及角度,获得数据运用统计学软件进行分析。结果头臂干(BCT)开口直径D1平均(15.2±3.0)mm,左颈总动脉(LCCA)开口直径D_2平均(11.8±2.2)mm,左锁骨下动脉(LSA)开口直径D_3平均(13.6±1.9)mm。BCT至LCCA距离E_1平均(4.0±2.5)mm,LCCA至LSA距离E2平均(8.2±3.7)mm。BCT、LCCA、LSA与主动脉弓所成切线角平均分别为α(29.5°±14.4°)、β(40.3°±17.5°)、γ(57.9°±21.6°)。Ⅰ型主动脉弓三分支开口中点连线成角Ф平均(144.1°±10.1°),LCCA中点至BCT和LSA中点连线的距离L平均(4.5±1.2)mm。男性D_2、D3长于女性;在19~40岁、41~60岁、≥61岁3个年龄组中D1逐渐增大,而α、γ逐渐减小;在41~60岁、≥61岁2个年龄组中D_2、D_3、E_2、L均大于19~40岁年龄组,而Ф均小于19~40岁年龄组,差异均有统计学意义(P<0.05)。结论本研究得到正常主动脉弓上分支血管直径和角度的数据,可为腔内修复主动脉弓的各类研究提供数据支持。

Objective To retrospective study the morphological features of normal aortic arch in population of Tianjin area by computed tomography angiography(CTA).Methods From Jan2016to Dec2016,142volunteers undergoing thoracic aorta CTA in our institution were retrospectively reviewed.In each patient,10measurements were made in GE AW4.6workstation,including diameters,distances,and angles of branch vessels of aortic arch.SPSS statistical software was used to analyze data.Results The diameter of the origin of brachiocephalic trunk(BCT)D1was(15.2±3.0)mm,left common carotid artery(LCCA)D2was(11.8±2.2)mm and left subclavian artery(LSA)D3was(13.6±1.9)mm.The distancebetween the BCT and the LCCA(E1)was(4.0±2.5)mm,between the LCCA and the LSA(E2)was(8.2±3.7)mm.The anglebetween the BCT and arch(α)was29.5°±14.4°,between the LCCA and arch(β)was40.3°±17.5°,between the LSA and archγwas57.9°±21.6°.The angle formed by BCT,LCCA,and LSA(Φ)was144.1°±10.1°.The distance between center of LCCAostia and line between center of ostia of BCT and LSA(L)was(4.5±1.2)mm.Values of D2and D3were larger in male thanthat in female.In the three age groups of19-40y,41-60y and≥61y,values of D1increased gradually,whileαandγdecreased gradually.When in the two age groups of41-60y and≥61y,values of D2,D3,E2and L were significantly largerthan those in the age group of19-40y,whileΦwas smaller(P<0.05).Conclusion The data obtained by this study on thediameter and angle of branching vessels arising from the normal aortic arch may provide support for various studies ofendovascular repair of aortic arch.