多层螺旋CT定量评估腹主动脉瘤弹性的可重复性及风险因素

发布时间：2018-08-03 11:36

【摘要】：目的探讨多层螺旋CT定量评价腹主动脉瘤弹性的可重复性与风险因素。资料与方法前瞻性研究54例肾下型腹主动脉瘤患者的腹主动脉CT血管成像资料。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扫描。在肾动脉水平和肾动脉下采用半自动分割软件计算主动脉弹性D值和脉搏波波速,比较不同水平腹主动脉弹性的差异,并进行一致性检验。结果腹主动脉瘤D_(肾动脉水平值)和D_(肾动脉下)值分别为(1.05±0.22)×10~(-5)/Pa、(0.49±0.18)×10~(-5)/Pa,对应的脉搏波波速分别为(9.68±1.09)m/s、(14.96±4.01)m/s。肾动脉水平主动脉弹性观察者内及观察者间组内相关系数分别为0.92、0.89,肾动脉下水平主动脉弹性观察者内及观察者间组内相关系数分别为0.85、0.79。Bland-Altman图显示绝大部分点位于95%一致性界限内,2个位置测量的观察者间差异分别为0.017×10~(-5)/Pa、0.010×10~(-5)/Pa,观察者内差异分别为0.013×10~(-5)/Pa、0.018×10~(-5)/Pa。多元分析显示,瘤体的弹性与体重指数、脉压、舒张压和腹主动脉瘤直径具有独立相关性(R~2=0.68)。结论多层螺旋CT定量评价腹主动脉瘤弹性值具有较高的稳定性。研究不同危险因素与腹主动脉瘤发生的相关性,有助于临床选择合适的治疗方式。
[Abstract]:Objective to investigate the reproducibility and risk factors of multislice spiral CT quantitative evaluation of abdominal aortic aneurysm elasticity. Materials and methods CT angiography of abdominal aorta in 54 patients with subrenal type abdominal aortic aneurysm was studied prospectively. All the subjects were scanned with 64 spiral CTs, retrospective ECG gating and segmental data acquisition. The elastic D value of aorta and pulse wave velocity were calculated by semi-automatic segmentation software at the renal artery level and under the renal artery. The differences of abdominal aortic elasticity at different levels were compared and the consistency was verified. Results the values of D _ (renal artery level) and D _ (renal artery) in abdominal aortic aneurysm were (1.05 卤0.22) 脳 10 ~ (-5) / Pa and (0.49 卤0.18) 脳 10 ~ (-5) / Pa, respectively. The corresponding pulse wave velocities were (9.68 卤1.09) m / s, (14.96 卤4.01) Ms / s, respectively. Intra-observer and inter-observer correlation coefficients of horizontal aortic elasticity of renal artery were 0.92n0.89, and the correlation coefficients of intra-observer and inter-observer of horizontal aortic elasticity under renal artery were 0.85-0.79.Bland-Altman, respectively. Most of them were located in 95%. Within the consistency limit, the differences between the two positions measured were 0.017 脳 10 ~ (-5) / P Pa0.010 脳 10 ~ (-5) / Pa, and 0.013 脳 10 ~ (-5) / -Pa0.018 脳 10 ~ (-5) / Pa, respectively. Multivariate analysis showed that there was an independent correlation between tumor elasticity and body mass index, pulse pressure, diastolic blood pressure and diameter of abdominal aortic aneurysm (RV _ 2N _ (0.68). Conclusion Multi-slice spiral CT has high stability in quantitative evaluation of abdominal aortic aneurysm. To study the correlation between different risk factors and the occurrence of abdominal aortic aneurysm is helpful for clinical selection of appropriate treatment methods.
【作者单位】：武汉大学人民医院放射科;中南民族大学生物医学工程学院医仪器教研室;
【基金】：国家自然科学基金(81601461)
【分类号】：R543.16;R816.2

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