256层CT评估Stanford B型主动脉夹层升主动脉弹性与冠状动脉狭窄的相关性

Evaluating the correlation between ascending aortic elasticity of Stanford B type aortic dissection and coronary stenosis by 256 slice spiral CT

目的:探讨256层CT心电门控扫描评估Stanford B型主动脉夹层升主动脉弹性的价值及其与冠状动脉狭窄的相关性。方法:搜集2018年12月-2020年10月本院诊断为Stanford B型主动脉夹层并行256层CT心电门控扫描患者中图像质量较好且无明显呼吸、心脏搏动伪影的56例纳为研究对象(男37例,女19例),分为冠状动脉狭窄阳性组(n=35)和冠状动脉狭窄阴性组(n=21),并根据狭窄程度将冠状动脉狭窄阳性组分为轻度、中度、重度狭窄3组。将原始数据间隔5%R-R间期进行多期相重建,测量并计算升主动脉的4个弹性指标:膨胀性(AoD)、顺应性(AoC)、僵硬度(AoSI)及相对直径变化率(%Ao),并参照Gensini标准行冠状动脉狭窄评分。结果:Stanford B型主动脉夹层升主动脉各弹性指标在冠状动脉狭窄阳性组与狭窄阴性组间差异具有统计学意义(P<0.05)。冠状动脉轻度狭窄组与中度狭窄组间除僵硬度外,其余各项弹性指标差异均无统计学意义。轻度狭窄组与重度狭窄组、中度狭窄组与重度狭窄组间各项指标差异均具有统计学意义(P<0.05)。冠状动脉狭窄评分(参照Gensini标准)与升主动脉各弹性指标具有显著相关性(P<0.01)。结论:运用256层CT心电门控扫描评估Stanford B型主动脉夹层动脉弹性及其与冠状动脉狭窄的相关性具有一定的可行性,且Stanford B型主动脉夹层的升主动脉弹性指标与冠状动脉狭窄程度存在相关性。

Objective:To evaluate the correlation between ascending aortic elasticity of Stanford B type aortic dissection and coronary stenosis using 256 slice spiral CT.Methods:From December 2018 to October 2020,56 patients(37 males and 19 females)with Stanford B type aortic dissection and undergoing 256 slice spiral CT angiography examination with good image and no obvious respiratory and heart beating artifacts were collected as the research objects.The patients were divided into stenosis positive group(n=35)and stenosis negative group(n=21).The stenosis positive group were divided into mild,moderate and severe groups according to the degree of stenosis.The ascending aortic images were reconstructed every 5%R-R intervals.The cross-sectional areas and diameters of aortic in each R-R interval were measured,then aortic distensibility(AoD),aortic compliance(AoC),aortic stiffness(AoSI)and diameter variation rate(%AO)were calculated to evaluate aortic elasticity.The extent of coronary stenosis was evaluated by Gensini score.Results:The aortic elastic index of ascending aortic had statistically significant differences between stenosis positive group and stenosis negative group(P<0.05).There was no significant difference in elasticity between mild and moderate coronary artery stenosis groups except stiffness.There were statistically significant differences between the mild stenosis group and the severe stenosis group(P<0.05).There were significant correlation between aortic elastic index and Gensini score(P<0.01).Conclusion:It is feasible to evaluate the arterial elasticity of Stanford type B aortic dissection and its correlation with coronary artery stenosis by using 256 slice spiral CT;the aortic elastic index of ascending aorta in Stanford type B aortic dissection is related to the degree of coronary artery stenosis.