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Published on: September 8, 2023
Computed Tomography Scan of the Aorta to Predict Type B Aortic Dissection
Han Lee1,2, Qing Zhou1,2, Haitao Zhang1
1Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.
Insights
This study identified key aortic morphological features, such as increased diameter and length, as high-risk indicators for type B aortic dissection (TBAD). A predictive model using these factors shows promise for early TBAD detection.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Aortic Disease Research
Background:
- Type B aortic dissection (TBAD) poses significant risks.
- Identifying high-risk morphological features is crucial for early detection and intervention.
Purpose of the Study:
- To identify high-risk morphological features in patients with type B aortic dissection (TBAD).
- To establish an early detection model for TBAD using these features.
Main Methods:
- Retrospective analysis of imaging data from 49 TBAD patients and 57 controls.
- Evaluation of aortic morphological parameters including diameter, length, direct distance, and tortuosity index.
- Development of a predictive model using logistic regression and ROC curve analysis.
Main Results:
- TBAD patients exhibited significantly larger aortic diameters and increased ascending aorta length.
- Elevated direct distance and tortuosity index of the ascending aorta were observed in the TBAD group.
- Systolic blood pressure, D3 diameter, and L1 length were identified as independent predictors; the model achieved an AUC of 0.831.
Conclusions:
- Aortic diameter, ascending aorta length, direct distance, and tortuosity index are valuable geometric risk factors for TBAD.
- The developed prediction model demonstrates good performance in identifying individuals at risk for TBAD.
Background:
The purpose of this study is to find the high-risk morphological features in type B aortic dissection (TBAD) population and to establish an early detection model.
Methods:
From June 2018 to February 2022, 234 patients came to our hospital because of chest pain. After examination and definite diagnosis, we excluded people with previous cardiovascular surgery history, connective tissue disease, aortic arch variation, valve malformation, and traumatic dissection. Finally, we included 49 patients in the TBAD group and 57 in the control group. The imaging data were retrospectively analyzed by Endosize (Therevna 3.1.40) software. The aortic morphological parameters mainly include diameter, length, direct distance, and tortuosity index. Multivariable logistic regression models were performed and systolic blood pressure (SBP), aortic diameter at the left common carotid artery (D3), and length of ascending aorta (L1) were chosen to build a model. The predictive capacity of the models was evaluated through the receiver operating characteristic (ROC) curve analysis.
Results:
The diameters in the ascending aorta and aortic arch are larger in the TBAD group (33.9 ± 5.9 vs. 37.8 ± 4.9 mm, p < 0.001; 28.2 ± 3.9 vs. 31.7 ± 3.0 mm, p < 0.001). The ascending aorta was significantly longer in the TBAD group (80.3 ± 11.7 vs. 92.3 ± 10.6 mm, p < 0.001). Besides, the direct distance and tortuosity index of the ascending aorta in the TBAD group increased significantly (69.8 ± 9.0 vs. 78.7 ± 8.8 mm, p < 0.001; 1.15 ± 0.05 vs. 1.17 ± 0.06, p < 0.05). Multivariable models demonstrated that SBP, aortic diameter at the left common carotid artery (D3), and length of ascending aorta (L1) were independent predictors of TBAD occurrence. Based on the ROC analysis, area under the ROC curve of the risk prediction models was 0.831.
Conclusion:
Morphological characteristic including diameter of total aorta, length of ascending aorta, direct distance of ascending aorta, and tortuosity index of ascending aorta are valuable geometric risk factors. Our model shows a good performance in predicting the incidence of TBAD.
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