摘要
目的分析腹部增强CT(CECT)对腹主动脉瘤(AAA)破裂风险的预测价值。方法纳入平顶山市第二人民医院2021年1月至2025年6月期间收治的110例AAA患者为研究对象,开展回顾性研究。依据是否出现AAA破裂将入组患者分为破裂组(40例)、未破裂组(70例),比较2组患者CT平扫及CECT参数间差异,分析AAA破裂的危险因素,统计CECT参数对AAA破裂的预测价值。结果CT平扫结果显示,破裂组的瘤体最大直径、囊状瘤体占比、斑块状钙化占比、腹壁血栓CT值、血栓厚度、高密度新月征占比均高于未破裂组(t=4.468,χ^(2)=12.122,χ^(2)=13.408,t=3.887,t=5.349,χ^(2)=20.708;均P<0.001)。CECT结果显示,破裂组的假腔占比、瘤颈角度、局灶强化占比、血管壁应力(PWS)、动脉期、静脉期、延迟期均高于未破裂组,血流剪切力(WSS)低于未破裂组(χ^(2)=10.646,t=4.311,χ^(2)=10.476,t=3.788,t=3.827,t=3.908,t=3.534,t=-11.451;均P<0.001)。Logistic多因素回归分析结果显示,瘤颈角度、PWS、WSS为AAA破裂的危险因素。通过绘制受试者工作特征曲线(ROC),瘤颈角度、PWS、WSS联合检测对AAA破裂的预测AUC值为0.941,高于瘤颈角度、PWS、WSS单独检测[曲线下面积(AUC)=0.853、0.856、0.858]。结论瘤颈角度、PWS增加,WSS降低为AAA破裂的危险因素,CECT能通过检测上述参数实现对AAA破裂风险的有效预测。
Objective Analyzing the predictive value of CECT for the risk of rupture of AAA.Methods A retrospective study was conducted on 110 AAA patients admitted to the Second People's Hospital of Pingdingshan from January 2021 to July 2025.According to whether AAA rupture occurred,the enrolled patients were divided into rupture group(40 cases)and non rupture group(70 cases).The differences in CT plain scan and CECT parameters between the two groups of patients were compared,and the risk factors for AAA rupture were analyzed.The predictive value of CECT parameters for AAA rupture was statistically analyzed.Results The CT plain scan results showed that the maximum diameter,proportion of plaque calcification,CT value of abdominal wall thrombus,thrombus thickness,and proportion of high-density crescent sign in the ruptured group were all higher than those in the unruptured group(t=4.468,χ^(2)=12.122,χ^(2)=13.408,t=3.887,t=5.349,χ^(2)=20.708;all P<0.001).The CECT results showed that the proportion of false lumen,neck angle,focal enhancement,PWS,arterial phase,venous phase,and delayed phase in the ruptured group were higher than those in the unruptured group,and the WSS was lower than that in the unruptured group(χ^(2)=10.646,t=4.311,χ^(2)=10.476,t=3.788,t=3.827,t=3.908,t=3.534,t=-11.451;all P<0.001).The results of logistic multiple regression analysis showed that neck angle,PWS,and WSS were risk factors for AAA rupture.By plotting the ROC,the combined detection of neck angle,PWS,and WSS predicted an AUC value of 0.941 for AAA rupture,which was higher than the AUC values of neck angle,PWS,and WSS detected separately(AUC=0.853、0.856、0.858).Conclusion The increase in neck angle and PWS,as well as the decrease in WSS,are risk factors for AAA rupture.CECT can effectively predict the risk of AAA rupture by detecting the above-mentioned valines.
作者
卢锐
李静
Lu Rui;Li Jing(CT Room,the Second People's Hospital of Pingdingshan,Pingdingshan 467002,China)
出处
《实用医技杂志》
2026年第1期41-45,共5页
Journal of Practical Medical Techniques
关键词
腹主动脉瘤
破裂
腹部计算机体层成像
预测价值
Abdominal aortic aneurysm
Rupture
Computed tomography of abdomen
Predictive value
