摘要
目的探讨CT血管造影(CTA)中升主动脉长度与最大直径预测主动脉夹层的可行性。方法选取自2012年1月至2019年12月中国医科大学附属盛京医院收治的323例急性A型主动脉夹层(ATAAD)患者为研究对象,将在ATAAD发病2年内已完成CTA检查的患者纳入ATAAD前期组(n=22)。将2019年1—12月接受主动脉CTA检查而未发生ATAAD者纳入非ATAAD组,其中,升主动脉最大直径<40mm者纳入健康组(n=211),升主动脉最大直径≥40 mm者纳入胸主动脉瘤组(n=70)。比较3组研究对象的升主动脉长度与最大直径,采用受试者工作特征(ROC)曲线评估预测准确性。结果健康组、胸主动脉瘤组、ATAAD前期组的升主动脉最大直径分别为(32.3±3.8)mm、(46.0±5.5)mm、(45.5±7.2)mm,胸主动脉瘤组、ATAAD前期组的升主动脉最大直径大于健康组(P<0.05),胸主动脉瘤组和ATAAD前期组升主动脉最大直径的差异无统计学意义(P>0.05)。健康组、胸主动脉瘤组、ATAAD前期组的升主动脉长度分别为(66.3±9.2)mm、(84.4±9.3)mm、(90.2±16.5)mm,组间两两比较,差异均有统计学意义(P<0.05)。升主动脉最大直径ROC曲线下面积为0.813,升主动脉长度ROC曲线下面积为0.872。在截止值55 mm处,升主动脉最大直径的阳性预测值为20.0%,而在相同特异度水平下,升主动脉长度的阳性预测值为70.0%。结论升主动脉长度比最大直径具有更好的诊断准确性,有助于提高ATAAD风险患者的识别率。
Objective To investigate the predictive value of ascending aorta length and maximum diameter in CT angiography(CTA)for aortic dissection.Methods A total of 323 acute type A aortic dissection(ATAAD)patients admitted to Shengjing Hospital of China Medical University from January 2012 to December 2019 were selected.Patients who had completed CTA examination within 2 years before ATAAD were included in the pre-ATAAD group(n=22).Patients without ATAAD who underwent CTA examination from January to December 2019 were included in the non-ATAAD group, those with the maximum diameter of ascending aorta <40 mm were included in the healthy group(n=211),and those with the maximum diameter of ascending aorta ≥40 mm were included in the thoracic aortic aneurysm group(n=70).Compared the length and maximum diameter of ascending aorta of these three groups.The receiver operating characteristic(ROC)curve was used to evaluate the prediction accuracy.Results The maximum diameterof ascending aorta in the healthy group, the thoracic aortic aneurysm group and the pre-ATAAD group were(32.3±3.8)mm,(46.0±5.5)mm and(45.5±7.2)mm, respectively.The maximum diameter of ascending aorta in the thoracic aortic aneurysm group and the pre-ATAAD group was greater than that in the healthy group(P<0.05).There was no significant difference in the maximum diameter of ascending aorta between the thoracic aortic aneurysm group and the pre-ATAAD group(P>0.05).The length of ascending aorta in the healthy group, the thoracic aortic aneurysm group and the pre-ATAAD group were(66.3±9.2)mm,(84.4±9.3)mm and(90.2±16.5)mm, respectively, and the differences among groups were statistically significant(P<0.05).The area under ROC curve of the maximum diameter and length of the ascending aorta was 0.813 and 0.872 respectively.At the 55 mm cut-off point, the positive predictive value of maximum diameterwas 20.0%.At the same specificity level, the positive predictive value of length was 70.0%.Conclusion Compared with the maximal diameter, the measurement of length has better diagnostic accuracy, which helps to improve the identification rate of patients at risk for ATAAD.
作者
贾晨红
赵玫
李晓东
JIA Chen-hong;ZHAO Mei;LI Xiao-dong(Department of Cardiology,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《临床军医杂志》
CAS
2021年第5期497-499,503,共4页
Clinical Journal of Medical Officers
基金
国家自然科学基金(81100161)。
关键词
升主动脉长度
升主动脉最大直径
主动脉夹层
Ascending aorta length
Ascending aorta maximum diameter
Aortic dissection
作者简介
第一作者:贾晨红(1978-),男,辽宁本溪人,主治医师;通信作者:李晓东,E-mail:lixd@sj-hospital.org。
