摘要
目的 探讨腹主动脉联合常规胸痛三联CT血管成像(triple rule-out computed tomography angiography, TRO-CTA)检查在急性胸痛患者检查中的价值。方法 回顾性纳入1 482例急性非创伤性胸痛患者,414例患者接受传统的TRO-CTA扫描,1 068例患者在临床医师的要求下接受包括腹主动脉的TRO-CTA扫描(TRO-CTAwAA)。两组患者主动脉期的扫描范围不同:常规TRO-CTA只扫描胸主动脉,TRO-CTAwAA扫描整个主动脉,其余所有的扫描参数均相同。采用卡方检验对两组主动脉主要血管异常(主动脉夹层、动脉瘤、穿透性溃疡、壁内血肿、血管闭塞和血栓形成)的检出率进行比较。采用方差分析(ANOVA)对两组辐射剂量(CTDIvol和DLP)和扫描时间进行比较。结果 TRO-CTAwAA组的主动脉异常检出率明显高于TRO-CTA组(35.1%vs. 4.8%,P<0.001)。在TRO-CTAwAA组中,有26.5%的血管异常在胸主动脉和腹主动脉上均可检出,另外8.6%只发生在腹主动脉上。两组间辐射剂量相比,TRO-CTAwAA组的总DLP明显高于常规TRO-CTA(P<0.001)。两组扫描时间对比差别无统计学意义(P=0.410)。结论 腹主动脉联合常规TRO-CTA检查,可显著提高急性胸痛患者主动脉血管异常的检出率,不增加检查流程。
Objective To investigate the value of abdominal aortic combined with routine one-stop triple rule-out computed tomography angiography(TRO-CTA)in the examination of patients with acute chest pain.Methods A total of 1482 patients with nontraumatic chest pain were included in this retrospective study.Of them 414 patients underwent the conventional TRO-CTA scanning while 1068 patients underwent TRO-CTA that included the abdominal aorta(TRO-CTAwAA)under the request of clinicians.All scanning parameters were the same,except the scanning range for the third phase in TRO-CTA:conventional TRO-CTA covered only the thoracic aorta,while TRO-CTAwAA extended to the entire aorta.Patient etiology was investigated and the detection rates of major vessel abnormalities(aortic dissection,aneurysm,penetrating ulcer,intramural hematoma,vascular occlusion,and thrombosis)between the two groups was compared using chi square tests.The radiation dose(CTDIvol and DLP)and scanning time between the two groups were compared using analysis of variance(ANOVA).Results The TRO-CTAwAA had significantly higher detection rate of major artery abnormalities than the TRO-CTA group(35.1%vs.4.8%,P<0.001).In the TRO-CTAwAA group,26.5%of the vascular anomalies were detected in both the thoracic and abdominal aortas,and another 8.6%were seen only in the abdominal aorta.With regard to the radiation dose between the two groups,the total DLP was significantly higher in the TRO-CTAwAA group than in the conventional TRO-CTA group(P<0.001).The two groups did not significantly differ in scanning time(P=0.410).Conclusion TRO-CTA with scan range including the abdominal aorta significantly improves the detection rate for major vessel abnormalities in patients with chest pain without increasing the examination process.
作者
屈婷婷
曹乐
李雅楠
陈丽虹
樊钢练
程燕南
郭银霞
郭建新
QU Tingting;CAO Le;LI Yanan;CHEN Lihong;FAN Ganglian;CHENG Yannan;GUO Yinxia;GUO Jianxin(Department of Medical Imaging,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2024年第4期542-546,共5页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
陕西省重点研发计划项目-一般项目(No.2023-YBSF-068)
陕西省重点研发计划项目-高校联合项目(No.2020GXLH-Y-026)。
关键词
胸痛
一站式胸痛三联CTA
腹主动脉CTA
检查流程
chest pain
one-stop triple rule-out computed tomography angiography(TRO-CTA)
abdominal aortic CTA
examination process
