Variations in the bifurcation level of the abdominal aorta, formation level of the inferior vena cava, and insertion level of the left renal vein into the inferior vena cava and their clinical importance in laparoscopic surgery

Objective: It is important to minimize the risk of major vascular injury during pneumoperitoneumestablishment in laparoscopic surgeries for patients with unusual variations in the levels of theabdominal aorta, the inferior vena cava (IVC), and the left renal vein, which will decrease the morbidityand mortality. The study aims to assess the variations regarding the bifurcation level of the abdominalaorta, formation level of the IVC, and insertion level of the left renal vein into the IVC.Methods: This retrospective study was conducted on 100 patients (50 males and 50 females) referred tothe Department of Radiology, Jordan University Hospital for abdomino-pelvic CT with intra-venouscontrast from January 2018 to December 2019. The three vessels were determined on the axial plane,the coronal plane, and the midsagittal plane. The central vertebral body height as well as the distance ofthe level of the point of interest to the upper end plate of the vertebrae were measured. Afterwards, theresults were classified into the following categories, upper end plate, lower end plate, intervertebral disc,upper half, and lower half of the vertebra.Results: The aortic bifurcation was mainly found at the level of the L4 vertebral body (65, 65%). In theremaining cases, the bifurcation was found to be variably located spanning from L3 in 11 (11%) cases to3 (3%) cases at L5. As for the iliocaval junction, the most common site was also at the level of L4 with41 (41%) cases followed by 39 (39%) cases at the level of L5, and 20 (20%) cases at the intervertebral discof L4/L5. The left renal vein most commonly joined the IVC at the level of L1 with 62 (62%) cases followedby 20 (20%) cases at the intervertebral disc T12/L1. There was wide variation in its entry to the IVCspanning from 4 (4%) cases at T12/L1 to 1 (1%) case at L4.Conclusion: The anatomical variation of the major vessels can be found in the normal population.Therefore, sufficient investigation of the anatomical position of these vessels is essential for patientsbefore laparoscopic surgery.

Correlation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast enhanced imagesCorrelation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast enhance

Objective:To investigate the correlation of abdominal aorta CT value,renal artery CT value and renal cortex thickness with renal cortex CT value on contrast enhanced 64-slice CT images.Methods:96patients(50 men and 46women;16~74years)with normal kidney function,which was confirmed by kidney function test were enrolled in this study,including bilateral kidneys of 92cases and unilateral kidney of 4cases(total of 188kidneys;92left,96right).After intravenous(IV)injection of contrast agent the kidneys of the selected patients were scanned by MDCT.The scans were performed in arterial,venous and 3min delayed phases.All statistical analyses were performed by using IBM SPSS 20.0.Graphs were generated using Graph Pad Prism 5software.Quantitative data were presented as mean±standard deviation,while qualitative data were presented as frequency(%).P<0.05was considered to be statistically significant.Results:The mean renal cortex thickness was(5.19±0.81)mm in all kidneys.In the arterial phase,a statistically significant positive correlation between renal cortex CT values and abdominal aortic CT values was showed(r=0.584;P<0.001).A statistically significant positive correlation between renal cortex CT values and renal cortex thickness was demonstrated(r=0.533,P<0.0001).Likewise,there was a positive correlation between renal cortex CT value and renal artery CT values(r=0.43,P<0.001).Conclusion:It is a promising approach to assess the individual kidney function by measuring abdominal aorta CT value,renal artery CT value,renal cortex CT value and renal cortex thickness using contrast MDCT.

Clinical analysis of abdominal aorta block in operation of gynecologic tumor

Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.

An Experimental Set-Up for the in Vitro Simulation of a Physiological Pulsatile Flow in the Abdominal Aorta

In vitro experimental set-up is an important tool for investigating abdominal aortic aneurysm (AAA). Accurate reproduction of the physiological pulsatile flow waveform in the abdominal aorta at various anatomic locations is an important component of these experimental methods. The objective of this study is to establish an experimental set-up to generate a physiological pulsatile flow for in vitro simulations of the abdominal aorta. The physiological flow was established by a computer-controlled peristaltic pump and the flow field in a circular straight pipe is measured under pulsatile flow conditions by a 2-dimensional particle image velocimetry system (2D-PIV). Experimental results show that the in vitro experimental set-up provides a flow with a period of 2 s, a reasonable cross-sectional velocity distribution and an approximate inlet velocity profile that is close to the human abdominal aorta.

Angiograms of the Abdominal Aorta in a Patient of Middle Aortic Syndrome

A 42-year old woman of middle aortic syndrome presented with severe hypertension for 20 years, whose abdominal aorta angiography revealed long segment and nearly complete occlusion in the mid portion of abdominal aorta, and extensively enlarged collateral vascular supply to the lower portion of abdominal aorta. The pressures proximal and distal to stenosis were 185/110 and 95/70 mmHg, and the pressure gradient across the stenosis was 90/40 mmHg. After the operation of thoraco-abdominal bypass graft, the pressure difference between the upper and lower extremities eventually disappeared.

Endoscopic trans-esophageal submucosal tunneling surgery:A new therapeutic approach for diseases located around the aorta ventralis

AIM To assess the efficiency of endoscopic trans-esophageal submucosal tunneling surgery(EESTS) technique for diseases located around the aorta ventralis.METHODS Nine pigs were assigned to EESTs. The procedures were as follows: First, a long esophageal submucosal tunnel was established. Second, full-thickness myotomy was created. Third, an endoscope was entered into the abdominal cavity through a muscle incision and the endoscope was around the aorta ventralis. Eventually,celiac trunk ganglion neurolysis, partial hepatectomy and splenectomy, partial tissue resection in the area of the posterior peritoneum, and endoscopic submucosal dissection(ESD) combined with lymph node dissection were performed. The animals were given antibiotics for 5 d and necropsied 7 d after surgery.RESULTS In all surgeries, one pig died from intraperitoneal hemorrhage after doing partial splenectomy, while the other pigs were alive after successfully operating other surgeries. For surgery of celiac trunk ganglion damage, at necropsy, there was no exudation in the abdominal cavity. Regarding surgery of partial hepatectomy, the wound with part healing was observed in the left hepatic lobe, and no bleeding or obvious exudation was seen. In surgery of partial splenectomy, massive hemorrhage was observed on the splenic wound surface, and the metal clips could not stop bleeding. After surgery of retroperitoneal tissue resection, mild tissue adhesion was observed in the abdominal cavity of one animal, and another one suffered from severe infection. For surgery of ESD and lymph node dissection, a moderate tissue adhesion was observed.CONCLUSION EESTS is a feasible and safe technique for diseases located around the aorta ventralis.

Detection of atherosclerotic plaque progression in the abdominal aorta of rabbits with 3T magnetic resonance imaging

Background With features of high tissue contrast, MRI can be used for the qualitative and quantitative evaluation of atherosclerosis plaques. In this study we investigated the development of atherosclerosis plaque with high resolution 3T MRI in a rabbit model and compared the findings with the histopathological results. Method Twenty male New Zealand white rabbits were randomly allocated into an experimental group （n=16） and a control group （n=4）. Atherosclerotic lesions were induced in the abdominal aorta by balloon injury and cholesterol feeding. Multiple sequences MRI examination （ToF, TIWI, T2WI, and CE T1WI） were performed at the 2nd, 3rd, and 4th months after aortic denudation. Vessel wall thickness, total vessel area, lumen area, and vessel wall area were recorded. Plaque components were analyzed using histological results as a standard reference. Results Seventeen rabbits （14 in the experimental group and 3 in the control group） received all three MR examinations. Gradually, from 2 months to 4 months, vessel wall thickness and area in the experimental group increased significantly compared with the control group （P 〈0.01）. In the lumen area progressive stenosis was not found, even a slight dilation had developed in the experimental group. Lipid, fibrotic and calcified plaques can be differentiated by MR image. According to histological results, MRI had good performance in detection of lipid plaque. Conclusion MRI can be used to monitor progression of atherosclerosis and differentiate plaque components.

AN EXPERIMENTAL STUDY OF INTRAVASCULAR STENT IN ABDOMINAL AORTA OF ATHEROSCLEROTIC MINIATURE PIGS

To study the effects of nitinol alloy stent in the treatment of atherosclerotic arterial stenosis, eight miniature pigs were subject to abdominal aortic balloon denudation and high-fatty food. Then 8 nitinol alloy stents were implanted into each abdominal aortas of pigs. The pigs were equally divided into two groups. One group was given captopril (3 mg / kg / d). All animals were sacrified) for pathological examination 6 to 10 months after stent implantation. The degree of arterial intima proliferation in the areas of stent implantation not significantly different from that of areas of balloon denudation alone; the atherosclerotic lesions were found at the arterial surface of stent implantation sites. The intima layer was rich in smooth muscle cells, with atherosclerotic plaque formed around the stent wire. On the other hand, significant decrease in arterial intima proliferation was found in group Ⅱ with no atherosclerotic plaque. The arterial stenosis resulting from atherosclerotic lesion could not be prevented by implantation of intravascular stent, and on the contrary, the mechanical stress of stent wire might worsen the atherosclerosis. Captopril might impede the development of atherosclerotic stenosis after stent implantation.

Application of abdominal aortic balloon occlusion followed by uterine artery embolization for the treatment of pernicious placenta previa complicated with placenta accreta during cesarean section

Objective:This study aimed to investigate the clinical effects of abdominal aortic balloon occlusion followed by uterine artery embolization for the treatment of pernicious placenta previa complicated with placenta accreta during cesarean section.Methods:We performed a retrospective analysis of the clinical data for 623 patients who experienced pernicious placenta previa complicated with placenta accreta and received treatment in our hospital from January 2013 to January 2019.All patients underwent abdominal aortic balloon occlusion before their cesarean section.Seventyeight patients received bilateral uterine artery embolization,and among them,placenta accreta was found at the opening of the cervix in 13 patients.Due to suturing difficulty after the removal of the placenta,gauze packing was used to temporarily compress the hemorrhage.As soon as the uterus was sutured,emergent bilateral uterine artery embolization was performed.Active bleeding was noted in the remaining 65 patients when the lower part of the uterus was pressed after the placenta was removed and the uterus was sutured,therefor,bilateral uterine artery embolization was performed urgently.Results:Of the 623 patients,545 patients underwent only abdominal aortic balloon occlusion and 78 patients underwent additional emergent bilateral uterine artery embolization due to hemorrhaging during or after their cesarean section.No hysterectomies were performed.In the 78 patients,the amount of bleeding was 800-3,200 ml with an average of 1,650 ml during the operation;the volume of blood transfused was 360-1,750 ml(average:960 ml).The fetal fluoroscopy time was 3–8 s(average:5 s).The dose of radiation exposure was(4.2±2.9) m Gy.Fetal appearance,pulse,grimace,activity,and respiration(Apgar) score were normal.No serious complications were observed during or after the operation in the follow-up visits.Conclusion:For patients with pernicious placenta previa complicated with placenta accreta who experience active bleeding after cesarean section and abdominal aortic balloon occlusion,bilateral uterine artery embolization can effectively reduce blood loss and requirement of blood transfusion during the operation,and lowers the risk of hysterectomy.

Abdominal aortic aneurysm screening during transthoracic echocardiography:Cardiologist and vascular medicine specialist interpretation

AIM: To study the interobserver variability between a cardiologist and vascular medicine specialist in the screening of the abdominal aorta during transthoracic echocardiography (TTE). METHODS: Consecutive patients, > 55 years of age, underwent abdominal aortic imaging following standard TTE. Two cardiologists and one vascular medicine specialist performed a blinded review of the images. Interobserver agreement of abdominal aortic size was determined by the correlation coefficient and paired t test. Interobserver reliability for each cardiologist was assessed using Bland-Altman plots. RESULTS: Ninety patients were studied. The mean age of patients was 72 ± 10 years and 48% were male. The mean aortic diameter was 2.31 ± 0.50 cm and 5 patients (5.5%) had an abdominal aortic aneurysm (AAA). The additional time required for the ab-dominal aortic images was 4.4 ± 0.9 min per patient. Interobserver agreement between the 2 cardiologist interpreters and the vascular medicine specialist was excellent (P > 0.05 for all comparisons). On Bland-Altman analysis ofinterobserver reliability, the 95% lower and upper limits for measurement by the cardiologists were 84% and 124% of that of the vascular specialist. CONCLUSION: The assessment of the abdominal aorta during a routine TTE performed by a cardiologist is accurate in comparison to that of a vascular medicine specialist. In selected patients undergoing TTE, the detection rate of AAA is significant. Additional time and effort required to perform imaging of the abdominal aorta after TTE is less than 5 min.

The clinical application of multi-slice spiral CT angiography in abdominal aortic disease

Objective： To evaluate the clinical application of multi-slice spiral CT angiography（MSCTA） in the assessment of abdominal aortic disease. Methods： Fifty-four patients underwent multi-slice spiral CT angiography of abdomen. Contrast agent （Omnipaque 300 I g/L） 1.5 ml/kg was injected and the injection rate was 3 ml/s. The delay time was determined by bolus tracking technique, Tll level abdominal aorta was set as the target vessel and the threshold was 180-200Hu, slice width was 3mm and with a pitch of 4-6. Original data were transferred to working-station to perform functional reconstruction. Results： Ten cases were normal, twenty-eight cases were abdominal aortic aneurysms, five abdominal aortic dissecting aneurysms （Debakay type Ⅲ） and eleven aortic sclerosis. SSD showed the body of aneurysm and the relationship between aneurysm and adjacent blood vessel, MIP better displayed calcification of blood vessel wall and condition of the stent, MPR demonstrated true and false lumen, rapture site of abdominal aorta intima and mural thrombus. Conelusion： MSCTA axial and reconstruction image can show the extent of abdominal aortic disease and the relationship with adjacent blood vessels. It is a safe, simple and non-invasive examination method.

Total Thrombosis of Bifurcated Endoprosthesis: A Rare Complication of Endovascular Treatment of Abdominal Aortic Aneurysm

Background: Aortic stents are a therapeutic alternative to open surgery of abdominal aortic aneurysms. We report a case of treatment of an abdominal aortic aneurysm with a bifurcated stent, complicated by total thrombosis. Aim: The purpose of this presentation was to understand the causes, mechanisms, incidents and accidents that contributed to this complication. Case Presentation: A 48-year-old man patient with a history of high blood pressure, ischemic heart disease, chronic obstructive pulmonary disease, who was found during a surveillance check-up, an infra-renal abdominal aorta aneurysm measured at 56 mm in diameter, asymptomatic but progressive. The indication of an endovascular treatment by the placement of a bifurcated prosthesis was posed and accepted. Thrombosis of the two limbs was intra-operative, upper-end migration without endoleak at 4 months postoperative, total thrombosis of the stent at 13 months postoperatively. Explantation of the stent followed by aortobi-iliac bypass was finally performed in the 15th month. Conclusion: The cardiopulmonary antecedents, the anatomical and evolutionary characteristics of the aneurysm could have played a role in the occurrence of the complications observed in this patient.

Multiple recurrent cystic echinococcosis with abdominal aortic involvement: A case report

BACKGROUND Recurrent cystic echinococcosis(CE)with vital organ involvement is a challenge for clinicians.Herein,we report a case of aortic involvement in recurrent retroperitoneal CE lesions following primary splenic CE resection.CASE SUMMARY A 60-year-old male was admitted due to progressive abdominal pain and poor appetite.He was diagnosed with multiple recurrent CE with abdominal aortic involvement according to preoperative evaluation.During surgical resection,major aortic bleeding accidentally occurred while dissecting the cyst,which was firmly attached to the abdominal aortic wall.Hemostasis attempts were conducted to deal with this emergency situation and maintain circulation.Postinterventional recovery was uneventful,and 2-year follow-up showed no sign of recurrence or any other complications.CONCLUSION Radical resection of recurrent complicated CE with aortic involvement should be carefully planned and performed to prevent possible severe adverse complications,thereby improving the postoperative outcome.

With autosomal dominant polycystic kidney disease,aortic dissection follows an abdominal aneurysm ten years later:a case report

A case of aortic dissection with a repaired abdominal aneurysm with prosthetic graft ten years ago in a 45-year-old woman is presented.Stanford type B dissection and multiple renal cysts diagnosed by contrast enhanced CT and an iliac false aneurysm by intraoperational angiography.Four stents were deployed to repair these arterial lesions with one fenestrated.With her only son revealed also with renal cysts by ultrasonogram,the diagnosis of autosomal dominant polycystic kidney disease (ADPKD) was confirmed.

Tuberculous Abdominal Aortic Aneurysm with Alimentary Tract Hemorrhage：A Case Report with Medico-legal Impli-cations

An autopsy case of sudden death induced by alimentary tract hemorrhage was presented,which was caused by the unexpected rupture of clinically unrecognized tuberculous abdominal aortic aneurysm(TAAA).The initial diagnosis was made of the syndrome of coronary heart disease and hypertensive disease.The detailed autopsy showed that the alimentary tract hemorrhage was caused by a sudden rupture of the mass after posture changing was ascertained as the cause of death.The diagnosis of TAAA was determined by the autopsy findings.Analysis for the medical dispute of TAAA was described,and the difficulty of the diagnosis and medico-legal implications were also discussed.

Transcriptome analysis reveals therapeutic potential of NAMPT in protecting against abdominal aortic aneurysm in human and mouse

Abdominal Aortic Aneurysm(AAA)is a life-threatening vascular disease characterized by the weakening and ballooning of the abdominal aorta,which has no effective therapeutic approaches due to unclear molecular mechanisms.Using single-cell RNA sequencing,we analyzed the molecular profile of individual cells within control and AAA abdominal aortas.We found cellular heterogeneity,with increased plasmacytoid dendritic cells and reduced endothelial cells and vascular smooth muscle cells(VSMCs)in AAA.Up-regulated genes in AAA were associated with muscle tissue development and apoptosis.Genes controlling VSMCs aberrant switch from contractile to synthetic phenotype were significantly enriched in AAA.Additionally,VSMCs in AAA exhibited cell senescence and impaired oxidative phosphorylation.Similar observations were made in a mouse model of AAA induced by Angiotensin II,further affirming the relevance of our findings to human AAA.The concurrence of gene expression changes between human and mouse highlighted the impairment of oxidative phosphorylation as a potential target for intervention.Nicotinamide phosphoribosyltransferase(NAMPT,also named VISFATIN)signaling emerged as a signature event in AAA.NAMPT was significantly downregulated in AAA.NAMPT-extracellular vesicles(EVs)derived from mesenchymal stem cells restored NAMPT levels,and offered protection against AAA.Furthermore,NAMPT-EVs not only repressed injuries,such as cell senescence and DNA damage,but also rescued impairments of oxidative phosphorylation in both mouse and human AAA models,suggesting NAMPT supplementation as a potential therapeutic approach for AAA treatment.These findings shed light on the cellular heterogeneity and injuries in AAA,and offered promising therapeutic intervention for AAA treatment.

剖宫产术中不同时机行腹主动脉球囊阻断对凶险性前置胎盘患者临床价值的Meta分析

目的系统评价剖宫产术中不同时机行腹主动脉球囊阻断对凶险性前置胎盘患者的临床价值。方法系统检索PubMed、Embase、Medline、Cochrane Library、Web of Science、中国知网、万方数据、维普、中国生物医学文献数据库等库至2024年3月1日关于不同时机行腹主动脉球囊阻断对凶险性前置胎盘的相关文献,由2名评价者独立筛选文献、提取数据,参照Cochrane协作网提供的偏倚风险评估工具对文献质量进行评估,选用RevMan 5.4.1进行Meta分析。结果共纳入10篇文献,885例凶险性前置胎盘患者。Meta分析结果显示,胎儿娩出前阻断可减少术中出血量[均数差(mean difference,MD)=-296.89,95%置信区间(confidence intervals,CI)=-433.65~-160.13,P<0.001]和输血量(MD=-2.30,95%CI=-3.92~-0.69,P=0.005),降低术后重症监护病房入住率[比值比(odds ratio,OR)=0.34,95%CI=0.19~0.63,P<0.001]和产后出血发生率(OR=0.44,95%CI=0.28~0.69,P<0.001),缩短手术时间(MD=-16.28,95%CI=-24.89~-7.67,P<0.001)和住院时间(MD=-0.89,95%CI=-1.19~-0.59,P<0.001),但不能降低术后并发症发生率(OR=0.53,95%CI=0.16~1.80,P=0.310)和子宫切除率(OR=0.59,95%CI=0.35~1.00,P=0.050)。结论与胎儿娩出后阻断相比,剖宫产术中胎儿娩出前行腹主动脉球囊阻断对凶险性前置胎盘患者的临床价值更高,且不会增加不良妊娠结局的发生率。

维持性血液透析患者血清骨膜蛋白与腹主动脉钙化的关联

目的探究维持性血液透析(maintenance hemodialysis,MHD)患者血清骨膜蛋白(periostin,POSTN)与腹主动脉钙化(abdominal aortic calcification,AAC)的关联。方法选择2022年10月─2023年10月于青岛市市立医院本部血液净化中心行MHD治疗>3个月的95例患者作为研究对象,收集研究对象的临床资料及实验室检查结果;ELISA检测所有入选者的血清POSTN水平;应用腹部侧位X线平片评估MHD患者的AAC情况,并计算AAC积分(abdominal aortic calcification score,AACs);采用Pearson相关性分析及单因素、多因素二元Logistic回归分析模型探究MHD患者腹主动脉钙化的危险因素。结果MHD患者组血清POSTN水平高于健康对照组(Z=-8.744,P<0.001)。相关性分析显示MHD患者血清POSTN水平与AACs、透析龄、甲状旁腺激素、β_(2)微球蛋白、低密度脂蛋白呈正相关(r=0.755、0.622、0.202、0.212、0.233,P<0.001、<0.001、0.049、0.039、0.023),与肾小球滤过率呈负相关(r=-0.695,P<0.001)。单因素及多因素二元Logistic回归分析结果:调整了透析龄、甲状旁腺激素等混杂因素后,血清POSTN水平是MHD患者发生腹主动脉中重度钙化的独立危险因素(OR=1.597,95%CI:1.005~2.536,P=0.047)。结论MHD患者的血清POSTN水平较健康人群高,且与腹主动脉钙化相关。

维持性血液透析患者血清β-catenin水平与腹主动脉钙化的关系

目的:探讨维持性血液透析(MHD)患者血清β-catenin水平与腹主动脉钙化(AAC)的关系。方法:选取上海交通大学医学院附属仁济医院宝山分院MHD患者70例,使用腹部侧位平片检测AAC情况,根据CORD研究分组方法,将患者分为无或轻度钙化组、中度钙化组和重度钙化组。采用ELISA法检测患者血清β-catenin水平,观察MHD患者血清β-catenin水平与AAC评分(AACS)及人口学特性和生化指标的关系。结果:本组MHD患者AAC发生率为70%。腹主动脉重度钙化组血清β-catenin水平显著高于中度钙化组、无或轻度钙化组(P<0.05);中度钙化组血清β-catenin水平亦高于无或轻度钙化组(P<0.05)。相关性分析结果显示,MHD患者血清β-catenin水平与AACS、透析龄、甲状旁腺激素、血磷成正相关。Logistic回归分析结果显示,β-catenin水平升高、高体质量指数及高C反应蛋白水平是MHD患者发生AAC的独立危险因素(P<0.05),而血清白蛋白水平升高则属于保护因素(P<0.05)。血清β-catenin预测AAC的曲线下面积(AUC)为0.864(95%CI 0.766~0.961,P=0.000),约登指数为0.693,对应血清β-catenin水平值为211.63 pg/ml,其预测AAC的灵敏度为91.70%,特异度为77.60%。结论:MHD患者血清β-catenin升高可能与AAC相关。

Revolution CT低剂量扫描方案对腹主动脉钙化的定量诊断价值

目的:探讨Revolution CT低剂量扫描方案对腹主动脉钙化的定量诊断价值。方法:搜集2021年9月至2022年3月宁夏医科大学总医院行CT尿路造影(CTU)合并腹主动脉钙化的35例患者,平扫采用GSI扫描模式联合40%全新迭代算法(ASiR-V)(A组),排泄期采用常规平扫(FBP重建)(B组)。测量两组图像的腹主动脉钙化指数(AACI)、腹主动脉CT值、SD值及A组腹主动脉钙化能谱定量参数(钙化体积、平均钙化浓度),计算A、B两组钙化质量积分、信噪比(SNR)和对比噪声比(CNR);并由2位医生对两组图像质量进行主观评分。采用Mann-Whitney U检验比较两组的AACI差异,采用配对样本t检验比较两组腹主动脉CT值、SD值、SNR及CNR差异。采用Pearson相关分析法对A组腹主动脉钙化各定量参数与B组AACI进行相关性分析,并对两组的辐射剂量进行比较。结果:A组AACI(0.20±0.03)与B组AACI(0.18±0.03)比较差异无统计学意义(P>0.05);A组腹主动脉钙化体积、平均钙化浓度、钙化质量积分与B组AACI间均呈正相关(r值分别为0.926、0.513、0.877,P<0.05)。A组SNR、CNR与B组比较差异有统计学意义(P<0.05)。两组图像的主观评分差异有统计学意义(P<0.05);A组的有效辐射剂量较B组降低了29.3%,差异有统计学意义(P<0.05)。结论:Revolution CT可为腹主动脉钙化的评估提供多种定量指标,测量过程简便、省时,更适合常规临床应用,低剂量扫描方案可以降低辐射剂量并提升图像质量。