Motion characterization of aortic wall and intimal flap by ECG-gated CT in patients with chronic B-dissection

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• 作者：Maria-Katharina Ganten ; Tim F. Weber ; Hendrik von Tengg-Kobligk ; Dittmar Bö ; ckler ; Wolfram Stiller ; Philipp Geisbü ; sch ; Gü ; nter W. Kauffmann ; Stefan Delorme ; Michael Bock ; Hans-Ulrich Kauc
• 关键词：MDCT ; ECG gating ; CT-angiography ; Aortic dissection ; Intimal flap motion ; Aortic distensibility
• 刊名：European Journal of Radiology
• 出版年：2009
• 出版时间：October 2009
• 年：2009
• 卷：72
• 期：1
• 页码：146-153
• 全文大小：516 K

文摘

Rationale and objectives

To evaluate whether dynamic computed tomography (CT)-imaging can provide functional vessel information in patients with chronic aortic dissection type Stanford-B (ADB).

Materials and methods

In 32 patients, ECG-gated CT-angiography images were obtained. Cross-sectional area change and wall distensibility were investigated by semiautomatic vessel area segmentation at the end of aortic arch. Significance of distensibility differences was tested with regard to the aortic diameter, and the oscillation of the intimal flap was analyzed.

Results

The aorta could be segmented successfully in all patients. These were separated into three subgroups: (A) 6 patients with an aortic diameter <4 cm and without a visible intimal flap, (B) 9 patients with an aortic diameter <4 cm, and (C) 17 individuals with an aortic diameter ≥4 cm; (B) and (C) having a visible intimal flap. Differences in distensibility between the subgroups were not significant. Overall mean distensibility was D_tot = (1.3 ± 0.6) × 10⁻⁵ Pa⁻¹. Analysis of intimal flap oscillation showed a pulsatile short axis diameter decrease of the true lumen of up to 29 % .

Conclusion

Dynamic, ECG-gated CT-angiography can demonstrate pulsatile changes in aortic area and a highly variable motion of the intimal flap. Aortic distensibility appears independent of diameter or presence of a intimal flap. Follow-up studies may show correlation with possible complications.