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在体内血动力学中,四维流程的间隔变化使B型大动脉剖析患者的大动脉生长分层化

Joshua Engel¹, Ozden Kilinc¹, Elizabeth Weiss²

¹Department of Radiology, Northwestern University, Chicago, Illinois, USA.

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

|August 4, 2024

概括

随着时间的推移,虚假流明 (FL) 最大速度和逆流,真实流明 (TL) 动能和最大速度的变化与B型大动脉剖析 (TBAD) 患者的大动脉生长率相关. 这些血液动力学变化可能有助于识别那些可能受益于早期干预的患者.

科学领域:

心血管成像 - 心血管成像
生物医学工程生物医学工程
胸部外科手术胸部外科手术

背景情况:

在B型大动脉剖析 (TBAD) 中,大动脉直径的增加增加增加了死亡风险.
胸内血管大动脉修复的早期干预可能会改善结果,但患者的选择是具有挑战性的.
四维 (4D) 流动心血管磁共振 (CMR) 评估TBAD中的血液动力学.

研究的目的:

调查4D流量衍生的血液动力学参数的纵向变化是否与TBAD患者的大动脉生长率相关.
确定这些血液动力学变化是否可以作为风险分层的预后标记.

主要方法:

基线和随访4D流量CMR (间隔≥120天) 的TBAD患者的回顾性分析.
排除在扫描前或扫描之间进行干预的患者.
对真光 (TL) 和假光 (FL) 动能 (KE),最大速度 (MV),平均向前流量 (FF) 和平均逆流量 (RF) 的voxel-wise计算.
计算所有血液动力学参数和大动脉生长率的随时间变化 (Δ).

主要成果:

包括32名TBAD患者 (平均年龄为56.9岁),平均随访时间为538天.
在整个队列中, Δ FL MV 和 Δ FL RF 与大动脉生长率相关.
在A型修复后残留剖析 (rTAAD) 患者中,Δ FL MV和Δ FL RF与生长率相关.
在 de novo TBAD (dnTBAD) 患者中, Δ TL KE 和 Δ TL MV 与生长率相关.

结论:

纵向4D流衍生的血液动力学变化与TBAD中的大动脉生长率相关.
这些血液动力学参数可能为风险分层提供额外的预后价值.
将4D流MRI整合到协议中可以帮助识别可能受益于预防性干预的TBAD患者.

关键词:

4D流量成像 4D流量成像动脉剖析是一个大动脉剖析.流动流动流动流动德瓦尔 (TEVAR) 是一个

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