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用MDCT测量的大动脉的化密度,用于评估大动脉狭窄的严重程度

Andréanne Powers¹, Mulham Ali², Nicolas Lavoie¹

¹Institut Universitaire de Cardiologie et Pneumologie de Québec (Quebec Heart & Lung Institute), Université Laval, Canada (A.P., N.L., N.S.B.M., L.T., C.R., M.-A.C.).

Circulation. Cardiovascular imaging

|May 21, 2024

概括

使用计算机断层扫描 (AVCd_CT) 的大动脉结石 (AVC) 索引优于回声心脏图 (AVCd_Echo) 评估大动脉狭窄的严重程度和预测死亡率. 当心声回声检查没有明确结果时,应使用AVCd_CT.

科学领域:

心脏病学心脏病学
放射学放射学是指放射学
医疗成像医学成像

背景情况:

大动脉结石化 (AVC) 索引到大动脉环 (AA) 区域通过多普勒心声学 (AVCd_Echo) 提供了在大动脉狭窄 (AS) 的预后价值.
使用多探测器计算机断层扫描 (AVCd_CT) 进行AS评估的AVC索引的实用性仍未评估.

研究的目的:

在AS患者的血液动力学相关性和临床结果方面比较AVC,AVCd_CT和AVCd_Echo.
评估AVCd_CT在预测AS患者死亡率方面的预后能力.

主要方法:

对889名患有性AS的患者进行了回顾性分析,这些患者接受了多普勒心声图和多探测器计算机断层扫描.
通过两种成像方法测量AA;使用按性别分层的ROC曲线分析确定AVCd_CT严重程度值.
主要终点是全因死亡率;次要终点是接受医疗治疗后的生存率.

主要成果:

与AVC和AVCd_Echo (P≤0.005) 相比,AVCd_CT与AS梯度/速度的相关性更强.
已确立的AVCd_CT严重AS的值:女性为334AU/cm2,男性为467AU/cm2.
在多变量分析中,AVCd_CT在预测全因死亡率和医疗治疗下的生存率方面显著超过AVC和AVCd_Echo (P<0.001).

结论:

在AS严重程度评估和死亡率预测方面,AVCd_CT与AVC和AVCd_Echo相当或优于AVC.
建议使用AVCd_CT来评估AS严重程度,特别是在没有确的心声回声检查结果的情况下.
拟议的AVCd_CT值为女性300AU/cm2,男性500AU/cm2以确定严重的AS,需要进一步验证.

关键词:

大动脉门狭窄症心声回声学,多普勒对应器血液动力学血液动力学多探测器计算机断层扫描.研究结果研究结果研究.

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