摘要
目的探讨主动脉壁间血肿(intramural hematoma,IMH)在计算机断层扫描血管造影(computed tomography angiography,CTA)上的影像学特点,并对量化后的主动脉壁间血肿形态学指标与血浆D-二聚体浓度进行相关性分析。方法回顾性分析2017年至2021年在深圳市龙岗区第二人民医院经CTA诊断为IMH的18例患者的临床资料。所得图像导入工作站进行计算机断层扫描(computed tomography,CT)三维重建。计算每个患者的血肿长度、血肿最大截面面积、血肿最大截面面积比、IMH狭窄率、血肿容积指数,并检测每位IMH患者的血浆D-二聚体浓度。按照血肿厚度和直径分为低风险组和高风险组,比较两组患者的血浆D-二聚体浓度有无统计学差异;并将血浆D-二聚体浓度分别和血肿长度、血肿最大截面面积比、管腔狭窄率、血肿容积指数4个IMH形态学指标进行相关性分析。结果(1)壁间血肿CTA特征主要表现为主动脉壁新月形或环形增厚,无内膜片移位,主动脉管腔受压,钙化内移,同时可伴有溃疡样突起和壁内血池。(2)高风险组与低风险组患者的血浆D-二聚体浓度比较,差异有统计学意义(P<0.05)。(3)血浆D-二聚体浓度与血肿体积指数之间呈正相关(r=0.550,P<0.05),血浆D-二聚体浓度与血肿长度、血肿最大截面面积比、IMH狭窄率之间相关性不显著(P>0.05)。结论量化后的CTA形态学指标联合血浆D-二聚体浓度对预测高风险IMH具有一定临床应用价值。
Objectives To investigate the imaging features of computed tomography angiography(CTA)of aortic intramural hematoma(IMH),and to analyze the correlation between the quantified IMH morphological indicators and the plasma concentration of D-dimer.Methods A retrospective analysis was performed on the clinical data of 18 patients diagnosed with aortic IMH by CTA in The Second People's Hospital of Longgang from 2017 to 2021.The obtained data was imported into the workstation,and the images were reconstructed by computed tomography(CT)in 3D.The hematoma length,hematoma cross-sectional area,hematoma maximum cross-sectional area ratio,lumen stenosis rate,and hematoma volume index were calculated in each case.At the same time,the plasma concentration of D-dimer of each IMH patient was measured.According to the thickness and diameter of the hematoma,the 18 patients were divided into low-risk group and high-risk group,and the plasma concentration of D-dimer of the two groups were compared to reveal if there was any statistical difference.Correlation analysis was carried out on the plasma concentration of D-dimer and hematoma length,hematoma maximum cross-sectional area ratio,lumen stenosis rate and hematoma volume index respectively.Results(1)The CTA features of IMH showed crescent or annular thickening of the aortic wall,no displacement of the aortic intima,compression of the aortic lumen,and inward displacement of calcified plaques,which might be accompanied by ulcer-like protrusions and intramural blood pool.(2)There was a statistically significant difference in the plasma concentration of D-dimer between high-risk group and low-risk group(P<0.05).(3)There was a positive correlation between the plasma concentration of D-dimer and the hematoma volume index(r=0.550,P<0.05),while there was no significant correlation between the D-dimer value and the hematoma length,hematoma maximum cross-sectional area ratio,and stenosis rate(P>0.05).Conclusions The quantified CTA morphological indicators combined with the plasma concentration of D-dimer has certain diagnostic values in predicting the high risk of IMH.
作者
弥龙
孙笑芬
刘旭东
伍保忠
陈建强
MI Long;SUN Xiaofeng;LIU Xudong;WU Baozhong;CHEN Jianqiang(Department of Medical Imaging,The Second People's Hospital of Longgang District,Shenzhen,Guangdong 518112,China;Department of Radiology,The First Affiliated Hospital of Hainan Medical University,Haikou 570102,China)
出处
《岭南心血管病杂志》
2025年第5期459-465,共7页
South China Journal of Cardiovascular Diseases
