640层容积CT评估肺动脉弹性及其与主动脉弹性的相关性
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摘要
目的探讨640层容积CT在肺动脉弹性评估中的可行性及其与主动脉弹性的相关性。资料与方法前瞻性收集2015年10月—2016年4月于我院行640层容积冠状动脉CT血管成像检查且符合纳入和排除标准的42例受检者。测量主肺动脉(MPA)、升主动脉(AA)、降主动脉(DA)感兴趣区管腔在收缩期与舒张期的最大及最小横截面积,计算弹性参数动脉扩张度(AD)。比较各血管间的AD值,分析各参数间的相关性。结果随心脏搏动,主肺动脉管径发生周期性变化。MPA、AA、DA的弹性不同,AD值依次为(7.94±3.04)×10~(-3)/mmHg、(4.02±2.16)×10~(-3)/mmHg和(3.23±1.46)×10~(-3)/mmHg。AA与DA、AA与MPA、DA与MPA呈正相关(r=0.689、0.520、0.393,P<0.001、P<0.05)。结论 640层容积CT结合回顾性心电门控技术可以在无需额外增加辐射剂量和对比剂用量的前提下,完成肺动脉弹性的评估,且肺动脉与主动脉弹性具有较好的相关性。
Purpose To explore the feasibility of 640-slice volume CT in the assessment of pulmonary artery elasticity and its correlation with aortic elasticity. Materials and Methods Forty-two subjects who underwent 640-slice volume CT coronary artery CTA examination in our hospital from October 2015 to April 2016 were prospectively admitted in this study according to the inclusion and exclusion criteria. The maximum and minimum cross-sectional area of region of interest(ROI) lumen of the main pulmonary artery(MPA), ascending aorta(AA), and descending aorta(DA) in the systolic and diastolic phases were measured, and the elastic parameter artery distensibility(AD) was calculated. The AD values among the blood vessels were compared, and the correlations among different parameters were analyzed. Results The main pulmonary artery diameter changed periodically along with cardiac impulse. As the elasticity of MPA, AA and DA varied, and the AD values were(7.94±3.04) ×10~(-3)/mm Hg,(4.02±2.16) ×10~(-3)/mm Hg, and(3.23±1.46) ×10~(-3)/mm Hg, respectively. The AA and DA, AA and MPA, DA and MPA showed a positive correlation(r=0.689, 0.520 and 0.393, P<0.001 and P<0.05), respectively. Conclusion The 640-slice volume CT combined with retrospective ECG-gating technique can complete the assessment of pulmonary artery elasticity without additional addition of radiation dose and contrast agent dosage, and the pulmonary artery has good correlation with aortic elasticity.
Purpose To explore the feasibility of 640-slice volume CT in the assessment of pulmonary artery elasticity and its correlation with aortic elasticity. Materials and Methods Forty-two subjects who underwent 640-slice volume CT coronary artery CTA examination in our hospital from October 2015 to April 2016 were prospectively admitted in this study according to the inclusion and exclusion criteria. The maximum and minimum cross-sectional area of region of interest(ROI) lumen of the main pulmonary artery(MPA), ascending aorta(AA), and descending aorta(DA) in the systolic and diastolic phases were measured, and the elastic parameter artery distensibility(AD) was calculated. The AD values among the blood vessels were compared, and the correlations among different parameters were analyzed. Results The main pulmonary artery diameter changed periodically along with cardiac impulse. As the elasticity of MPA, AA and DA varied, and the AD values were(7.94±3.04) ×10~(-3)/mm Hg,(4.02±2.16) ×10~(-3)/mm Hg, and(3.23±1.46) ×10~(-3)/mm Hg, respectively. The AA and DA, AA and MPA, DA and MPA showed a positive correlation(r=0.689, 0.520 and 0.393, P<0.001 and P<0.05), respectively. Conclusion The 640-slice volume CT combined with retrospective ECG-gating technique can complete the assessment of pulmonary artery elasticity without additional addition of radiation dose and contrast agent dosage, and the pulmonary artery has good correlation with aortic elasticity.
引文
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[14]李一丹,吕秀章,王怡丹,等.超声心动图无创评价肺动脉高压血流动力学临床应用.中国超声医学杂志,2015,31(11):971-974.
[15]李宁.DSCT在动脉弹性功能评估中的应用价值研究.山东大学,2012:54-55.
[16]Xu L,Chen J,Yin M,et al.Assessment of stiffness changes in the ex vivo porcine aortic wall using magnetic resonance elastography.Magn Reson Imaging,2012,30(1):122-127.
[17]Zhang N,Chen J,Yin M,et al.Quantification of regional aortic stiffness using MR elastography:a phantom and ex-vivo porcine aorta study.Magn Reson Imaging,2016,34(2):91-96.
[18]Schlicht MS,Khanafer K,Duprey A,et al.Experimental foundation for in vivo measurement of the elasticity of the aorta in computed tomography angiography.Eur J Vasc Endovasc Surg,2013,46(4):447-452.
[19]Jang S,Yong HS,Doo KW,et al.Relation of aortic calcification,wall thickness,and distensibility with severity of coronary artery disease:evaluation with coronary CTangiography.Acta Radiol,2012,53(8):839-844.
[2]Jiang L,Chen H,Li R,et al.Associations of arterial distensibility between carotid arteries and abdominal aorta by MR.J Magn Reson Imaging,2015,41(4):1138-1142.
[3]韩善良,李亮,林苑,等.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.中国医学影像学杂志,2017,25(10):767-771.
[4]柴亚欣,牛玉军,陈大鹏.CT对心外膜脂肪体积与升主动脉弹性的相关性.中国医学影像学杂志,2017,25(7):525-529.
[5]Bellofiore A,Roldán-Alzate A,Besse M,et al.Impact of acute pulmonary embolization on arterial stiffening and right ventricular function in dogs.Ann Biomed Eng,2013,41(1):195-204.
[6]Tian L,Kellihan HB,Henningsen J,et al.Pulmonary artery relative area change is inversely related to ex vivo measured arterial elastic modulus in the canine model of acute pulmonary embolization.J Biomech,2014,47(12):2904-2910.
[7]王闻,鲍海华.磁共振相位对比法对慢性高原病患者主肺动脉改变初步研究.磁共振成像,2018,9(8):595-599.
[8]Liang W,Chen D,Chen W,et al.The ascending aortic elasticity feature in normotensive subjects:evaluation with coronary CT angiography.Clin Imaging,2014,38(5):686-692.
[9]Wan Z,Liu X,Wang X,et al.Small artery elasticity predicts future cardiovascular events in Chinese patients with angiographic coronary artery disease.Angiology,2014,65(4):298-302.
[10]Swift AJ,Rajaram S,Condliffe R,et al.Pulmonary artery relative area change detects mild elevations in pulmonary vascular resistance and predicts adverse outcome in pulmonary hypertension.Invest Radiol,2012,47(10):571-577.
[11]Gan CT,Lankhaar JW,Westerhof N,et al.Noninvasively assessed pulmonary artery stiffness predicts mortality in pulmonary arterial hypertension.Chest,2007,132(6):1906-1912.
[12]Selimovic N,Rundqvist B,Bergh CH,et al.Assessment of pulmonary vascular resistance by Doppler echocardiography in patients with pulmonary arterial hypertension.J Heart Lung Transplant,2007,26(9):927-934.
[13]蔡燕娟,罗孝勇,陈权.连续多普勒超声评估特发性肺动脉高压患者不同时相肺动脉压与心导管检测的相关性研究.临床超声医学杂志,2017,19(9):593-596.
[14]李一丹,吕秀章,王怡丹,等.超声心动图无创评价肺动脉高压血流动力学临床应用.中国超声医学杂志,2015,31(11):971-974.
[15]李宁.DSCT在动脉弹性功能评估中的应用价值研究.山东大学,2012:54-55.
[16]Xu L,Chen J,Yin M,et al.Assessment of stiffness changes in the ex vivo porcine aortic wall using magnetic resonance elastography.Magn Reson Imaging,2012,30(1):122-127.
[17]Zhang N,Chen J,Yin M,et al.Quantification of regional aortic stiffness using MR elastography:a phantom and ex-vivo porcine aorta study.Magn Reson Imaging,2016,34(2):91-96.
[18]Schlicht MS,Khanafer K,Duprey A,et al.Experimental foundation for in vivo measurement of the elasticity of the aorta in computed tomography angiography.Eur J Vasc Endovasc Surg,2013,46(4):447-452.
[19]Jang S,Yong HS,Doo KW,et al.Relation of aortic calcification,wall thickness,and distensibility with severity of coronary artery disease:evaluation with coronary CTangiography.Acta Radiol,2012,53(8):839-844.