在无复杂的B型大动脉剖析中,大动脉周周脂肪衰减指数的预后影响
Yusuke Adachi1,2,3, Kazutaka Ueda1, Yuka Otaki2
1Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Radiology. Cardiothoracic imaging
|October 30, 2025
概括
在非对比CT上较高的峰值脂肪减弱指数 (FAI) 独立预测B型大动脉解剖无并发症 (TBAD) 患者的不良事件. 这一发现有助于通过识别高风险个体来管理TBAD.
科学领域:
- 放射学和成像科学 放射学和成像科学
- 心血管疾病研究研究
- 医学诊断 医学诊断 医学诊断
背景情况:
- 不复杂的B型大动脉剖析 (TBAD) 管理需要准确的预后工具.
- 在非对比CT图像上,大心周脂肪衰减指数 (FAI) 不侵入性地反映了血管炎症.
- 在TBAD中FAI的预后价值尚未完全确定.
研究的目的:
- 评估在没有并发症的B型大动脉解剖 (TBAD) 患者中围心脏脂肪衰减指数 (FAI) 的预后意义.
- 评估FAI在这个患者队伍中预测不良结果的能力,包括全因死亡和大动脉事件.
主要方法:
- 从2011年1月到2022年12月进行的一项回顾性多中心研究,分析了2011年1月至2022年12月的非对比CT扫描.
- 自动机器学习算法测量了下降胸前大动脉的周心脏FAI.
- 用于对135名没有并发症的TBAD患者的预后评估的多变量考克斯比例危险回归.
主要成果:
- 患有急性大动脉剖析 (A型和B型) 的患者与没有剖析的患者相比,FAI值更高 (中位数为-74.5vs-78.7HU;P<.001).
- 在没有并发症的TBAD中,FAI峰值发生在发病后6天左右.
- 较高的峰值FAI值 (≥-64 HU) 与明显更高的全因死亡率和大动脉事件相关 (日志等级P < .001) 并独立预测这些事件 (aHR,4.54;P = .003).
结论:
- 升高的峰值周动脉脂肪衰减指数 (FAI) 是B型大动脉解剖无并发症 (TBAD) 患者不良后果的独立风险因素.
- 在非对比CT上FAI测量提供了一个有价值的,非侵入性的工具,用于管理不复杂的TBAD的风险分层.
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