论文部分内容阅读
目的探讨心电门控技术64排CT评价肾下型腹主动脉瘤主动脉弹性的临床价值。方法 26例受检者分为腹主动脉瘤组13例,正常对照者组13例,均行腹主动脉CTA检查。两组间受检者性别及年龄完全匹配。所有受检者均采用64排螺旋CT、回顾性心电门控技术和分段数据采集方式。获得的原始数据分别在0%~95%R-R间期、间隔5%重组图像,然后在肾动脉水平(renal)和肾动脉下(infrarenal)采用MATLAB图像分割软件,分别测量各重建期相主动脉的横断面积。完成CT扫描后由专人常规测量受检者血压。最后通过公式计算主动脉弹性D值和脉搏波波速(PWV)。结果腹主动脉瘤组D_(renal)值和D_(infra)值分别为(1.21±0.40)×10~(-5)Pa~(-1)、(0.68±0.36)×10~(-5)Pa~(-1),对应的PWV值分别为(9.19±1.59)m/s、(13.37±4.84)m/s。正常对照组D_(renal)值和D_(infra)值分别为(1.92±0.27)×10~(-5)Pa~(-1)、(1.24±0.37)×10~(-5)Pa~(-1),对应的PWV值分别为(7.07±0.52)m/s和(9.15±2.04)m/s。腹主动脉瘤组及对照组内D_(renal)值、D_(infra)值差异有统计学意义(t值分别为5.668、7.966,P值均<0.05),其Drenal值均大于Dinfra值。腹主动脉瘤组与对照组间Drenal值比较差异有统计学意义(t值为-5.852,P值<0.05),两组间Dinfra值的差异亦有统计学意义(t值为-4.417,P值<0.05),腹主动脉瘤组均小于对照组,D值对应的PWV值比较也有一致的结果。Bland-Altman一致性检验显示心电门控64排CT所测得腹主动脉弹性值观察者间、观察者内相关性良好,一致性较高。结论心电门控64排CT可以定量评价肾下型腹主动脉瘤的弹性变化。肾下型腹主动脉瘤弹性较正常腹主动脉下降,而且正常瘤体近端主动脉的弹性也下降。
Objective To evaluate the clinical value of 64-slice CT with ECG-gated technique in evaluating aortic elasticity of sub-type abdominal aortic aneurysms. Methods Twenty-six subjects were divided into abdominal aortic aneurysm group (n = 13) and normal control group (n = 13). All patients underwent abdominal aorta CTA. Subjects of both groups were perfectly matched in gender and age. All subjects were using 64-slice spiral CT, retrospective ECG gating technology and segmented data collection methods. The original data obtained were respectively 0% to 95% RR interval and 5% interval image reconstruction. Then, the images of the renal arteries and infrarenal were divided by MATLAB software to measure the changes of the aorta The cross-sectional area. Subjects routinely measure the subject’s blood pressure after completing a CT scan. Finally, the formula to calculate the aortic elastic D value and pulse wave velocity (PWV). Results The values of renal and infra in abdominal aortic aneurysm group were (1.21 ± 0.40) × 10 ~ (-5) Pa ~ (-1) and (0.68 ± 0.36) × 10 ~ (-5) Pa ~ (-1) and corresponding PWV values were (9.19 ± 1.59) m / s and (13.37 ± 4.84) m / s, respectively. The values of renal and infra in normal control group were (1.92 ± 0.27) × 10 -5 Pa -1, 1.24 ± 0.37 × 10 -5 Pa ~ -1), corresponding to PWV values of (7.07 ± 0.52) m / s and (9.15 ± 2.04) m / s, respectively. The values of D_ (renal) and D_ (infra) in abdominal aortic aneurysm group and control group were statistically significant (t = 5.668 and 7.966, P <0.05 respectively), and their Drenal values were all higher than Dinfra values. There was significant difference in Drenal value between abdominal aortic aneurysm group and control group (t value was -5.852, P value <0.05), and the difference of Dinfra value between the two groups was also statistically significant (t value was -4.417, P Value <0.05), abdominal aortic aneurysm group were less than the control group, PWV value corresponding to the value of D also have consistent results. Bland-Altman’s consistency test showed that there was a good correlation between observer’s intra-observer elasticity and observer’s consistency of the abdominal aorta measured by 64-slice CT. Conclusion ECG-gated 64-slice CT can quantitatively evaluate the elastic changes of sub-type abdominal aortic aneurysms. Subarachnoid abdominal aortic aneurysm elasticity than the normal abdominal aorta down, but also the normal proximal aortic aneurysm flexibility also declined.