Purpose

To investigate the correlation between dynamic morphological parameters of retrospective cardiac gating CT angiography (CTA) and delayed adverse event (DAE) in uncomplicated type B acute aortic dissection (uTB-AAD) patients.

Materials and Methods

Eighty-seven patients initially diagnosed with uTB-AAD were retrospectively reviewed. Dynamic variables obtained by dose-regulated retrospective CTA were recorded, including the minimum relative true lumen diameter (RTLA_min), ratio of the minimum to maximum true lumen relative area (r-RTLA), the maximum diameter of the descending aorta, false lumen, and primary entry tear. Outcome analysis comprised incidences of DAE and early mortality within 3 to 14 days since symptom occurring.

Results

Twenty-six patients (29.9%) developed DAE, and two of which (7.7%) died before any interventions. Smaller values of RTLA_min (P = 0.01) and r-RTLA at the upper thoracic descending aorta (UTDA) (P < 0.001), and r-RTLA at the renal artery level (P = 0.016) demonstrated higher incidences of DAE; maximum diameter of the descending aorta (P < 0.001), the false lumen (P = 0.008), and entry tear size (P = 0.007) were positively associated with the occurrence of DAE. r-RTLA at the UTDA level yielded the highest diagnostic accuracy (82.0%) in detecting DAE at an optimal cutoff value of 61.7% (AUC = 0.839). Performance of dynamic characteristics was superior to static features obtained from single-phase image in the detection of DAE (P < 0.001).

Conclusion

Dynamic morphological features of retrospective cardiac gating CTA might aid in identifying a high risk of DAE in uTB-AAD patients and guiding early targeted interventions.

中文翻译：

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回顾性心脏门控CT血管造影的动态影像学特征影响急性简单B型主动脉夹层中延迟不良事件的发生

目的

目的探讨单纯性B型急性主动脉夹层（uTB-AAD）患者回顾性心脏门控CT血管造影（CTA）动态形态学参数与迟发性不良事件（DAE）之间的相关性。

材料和方法

回顾性分析了最初诊断为uTB-AAD的87例患者。记录通过剂量调节的回顾性CTA获得的动态变量，包括最小相对真实管腔直径（RTLA _min），最小与最大真实管腔相对面积之比（r-RTLA），降主动脉的最大直径，假管腔，以及主要入口撕裂。结果分析包括症状发生后3到14天内的DAE发生率和早期死亡率。

结果

26例患者（29.9％）患了DAE，其中2例（7.7％）在进行任何干预前死亡。较小的RTLA _min（P  = 0.01）和r-RTLA在上胸主动脉降支（UTDA）（P  <0.001）和r-RTLA在肾动脉水平（P  = 0.016）较小，这说明DAE的发生率较高。降主动脉最大直径（P  <0.001），假管腔（P  = 0.008）和入口撕裂尺寸（P = 0.007）与DAE的发生呈正相关。在检测DAE时，UTDA级别的r-RTLA的诊断准确度最高（82.0％），最佳临界值为61.7％（AUC = 0.839）。在DAE的检测中，动态特性的性能优于从单相图像获得的静态特性（P  <0.001）。

结论

回顾性心脏门控CTA的动态形态学特征可能有助于确定uTB-AAD患者DAE的高风险并指导早期靶向治疗。