| 孙媛媛,李丽华,庄晖,苏茂龙,王心宇,陈彩妹,张国明,陈旭.超声造影评估DeBakey Ⅰ型主动脉夹层累及肾动脉[J].中国医学影像技术,2025,41(2):273~276 |
| 超声造影评估DeBakey Ⅰ型主动脉夹层累及肾动脉 |
| Contrast-enhanced ultrasound for evaluating DeBakey Ⅰ aortic dissection involved renal artery |
| 投稿时间：2024-08-26 修订日期：2025-01-09 |
| DOI：10.13929/j.issn.1003-3289.2025.02.019 |
| 中文关键词: 主动脉夹层 肾动脉 超声检查 |
| 英文关键词:dissection of aorta renal artery ultrasonography |
| 基金项目:福建省自然科学基金(2023J011676)。 |
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| 中文摘要: |
| 目的 观察超声造影(CEUS)评估DeBakey Ⅰ型主动脉夹层累及肾动脉的价值。方法 回顾性分析137例DeBakey Ⅰ型主动脉夹层累及肾动脉患者,其中132例单侧、5例双侧肾动脉受累。观察双肾共274支肾动脉开口,以CT血管造影(CTA)为参考标准,将肾动脉开口于真腔视为未受累、开口于假腔及真假腔视为受累,对比观察CEUS表现及其鉴别DeBakey Ⅰ型主动脉夹层是否累及肾动脉的价值。结果 CTA显示肾动脉开口于真腔132支、假腔90支及真假腔52支。CEUS诊断肾动脉开口于真腔131支、假腔111支及真假腔32支,据以诊断DeBakey Ⅰ型主动脉夹层累及肾动脉的敏感度分别为90.84%、81.08%及90.63%。CEUS评估肾动脉开口于真、假腔结果与CTA所见的一致性较好(Kappa值=0.786)。logistic回归分析显示,时间强度曲线(TIC)所示达峰时间(TTP)和峰值强度(PI)均为鉴别肾动脉开口于真腔与假腔、真腔与真假腔的影响因素,而TIC曲线下面积(AUC)为鉴别真、假腔的影响因素(P均＜0.05)。以TIC所示TTP、PI及AUC联合鉴别肾动脉开口于真腔与假腔、真腔与真假腔、假腔与真假腔的受试者工作特征曲线的AUC分别为0.703、0.686及0.493。结论 CEUS有助于评估DeBakey Ⅰ型主动脉夹层累及肾动脉。 |
| 英文摘要: |
| Objective To observe the value of contrast-enhanced ultrasound (CEUS) for evaluating DeBakey Ⅰ aortic dissection involved renal artery. Methods Totally 137 patients with DeBakey Ⅰ aortic dissection involved renal artery were retrospectively enrolled, including 132 cases involved unilateral and 5 cases involved bilateral renal arteries. The opening of totally 274 renal arteries in bilateral kidneys were observed. Taken CT angiography (CTA) as reference standard, the renal artery opened in true lumen was considered as unaffected, while opened in false lumen or true-false lumen were both considered as affected. Relative CEUS manifestations were observed, and their value for evaluating involved renal artery or not were analyzed. Results CTA showed that 132 renal arteries opened in true lumens, 90 opened in false lumens and 52 opened in true-false lumens. CEUS diagnosed 131 renal arteries opened in true lumens, 111 opened in false lumens and 32 opened in true-false lumens, and the sensitivity for diagnosing DeBakey Ⅰ aortic dissection involved renal artery was 90.84%, 81.08% and 90.63%, respectively. The consistency between CEUS and CTA for evaluating renal artery opened in true lumen or false lumen was good (Kappa=0.786). Logistic regression analysis showed that the time to peak (TTP) and peak intensity (PI) of time intensity curve (TIC) were both impact factors for differentiating renal artery opened in true lumen or false lumen, as well as true lumen or true-false lumen (both P＜0.05), while the area under the curve (AUC) of TIC was impact factor for differentiating renal artery opened in true lumen or false lumen (P＜0.05). The AUC of receiver operating characteristic curve of the combination of TTP, PI and AUC of TIC for differentiating renal artery opened in true lumen or false lumen, true lumen or true-false lumen and false lumen or true-false lumen was 0.703, 0.686 and 0.493, respectively. Conclusion CEUS was helpful for evaluating DeBakey Ⅰ aortic dissection involved renal artery. |
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