论文部分内容阅读
目的:采用4D-flow MRI分析主动脉夹层(AD)患者腹部真腔和假腔内的血流动力学特点,以及各血流指标与夹层破口大小、数量及假腔内血栓之间的相关性,探讨其临床应用可行性及诊断价值。方法:16例主动脉夹层患者采用4DFlow MRI技术进行腹主动脉成像,同时行胸腹主动脉CTA检查。对腹主动脉4个层面的图像进行分析,测量各层面真腔和假腔的横断面积、血流速度、峰值速度、平均净流量、最大流量、净正向血容量及反流分数,并观察主动脉夹层各种形态学指标。真假腔各血流指标及面积的比较采用配对t检验,AD的各形态学指标与血流指标的关系采用Pearson相关分析和多元线性回归分析。结果:腹主动脉各水平真腔的平均横断面积及反流分数均小于假腔,真腔内血流速度、峰值速度、平均净流量、最大流量、净正向血容量均明显高于假腔,两组间差异均有统计学意义(P<0.05)。夹层破口越大,真腔血流速度及流量越小(P<0.05),而假腔的平均血流速度、平均净流量及最大流量越高(P<0.05)。随破口数量增多,真腔各血流指标增高(P<0.05),假腔最大流量变小(P=0.025)。假腔有血栓形成,则真腔平均血流速度、峰值速度增高(P=0.003、0.005)。破口大小对真假腔血流指标的影响意义较大。结论:4DFlow MRI技术能够定性、定量地提供主动脉夹层患者的腹主动脉血流信息,在主动脉夹层的诊断和治疗方案的选择中有重要的临床应用价值。
OBJECTIVE: To analyze the hemodynamic characteristics of the abdominal cavity and the false lumen in patients with aortic dissection (AD) by using 4D-flow MRI and the relationship between the indexes of blood flow and the size and number of dissection incision and thrombus in the fistula To explore the feasibility of its clinical application and diagnostic value. Methods: 16 patients with aortic dissection using 4DFlow MRI technique for abdominal aorta imaging, while the thoracoabdominal aorta CTA. The images of 4 layers of abdominal aorta were analyzed and the cross-sectional area, velocity, peak velocity, average net flow, maximum flow, net positive blood volume and reflux fraction of true and false lumen at each level were measured and observed Aortic dissection of various morphological indicators. True and false lumen of the various blood flow indicators and area comparison using paired t test, AD morphological indicators and blood flow indicators using Pearson correlation analysis and multiple linear regression analysis. Results: The mean cross-sectional area and reflux fraction of true lumen of abdominal aorta were all less than those of false lumen. The true lumen velocity, peak velocity, average net flow, maximum flow and net positive blood volume were significantly higher than those of false lumen , The differences between the two groups were statistically significant (P <0.05). The larger the lamellar breach, the smaller the true lumen velocity and flow (P <0.05), while the average lumen velocity, mean net flow and maximum flow (P <0.05). With the increase of the number of incisions, the indexes of all blood flow in the true lumen increased (P <0.05), and the maximal flow of the false lumen decreased (P = 0.025). False cavity thrombosis, true cavity average blood flow velocity, peak velocity increased (P = 0.003,0.005). The size of the impact on true and false lumen blood flow index significance. Conclusion: The 4DFlow MRI technique can qualitatively and quantitatively provide abdominal aorta blood flow information in patients with aortic dissection. It has important clinical value in the diagnosis and treatment of aortic dissection.