71例腹主动脉瘤的基线CT特征与病变进展的相关性

目的 评估与腹主动脉瘤(AAA)进展相关的基线CT特征,为AAA的临床治疗路径提供参考。 方法 选取2012年1月至2021年12月至少行两次增强CT扫描的83例AAA患者的临床及影像资料进行分析,两次扫描间隔3个月以上。测量瘤体的直径、面积、长度、曲度、血栓面积等基线CT特征,并根据瘤体直径计算AAA的年进展速度。将有进展的AAA分为缓慢进展组(进展速度≤0.25 cm/y)和快速进展组(进展速度>0.25 cm/y)。采用独立样本t检验或Mann-Whitney U非参数检验进行组间比较;运用单变量与多变量线性回归分析,确定与AAA 进展有关的基线CT特征。 结果 71例患者存在病变进展,其中缓慢进展组35例,快速进展组36例。快速进展组的基线瘤体长度显著大于缓慢进展组(P=0.03)。多因素相关性分析结果显示,瘤体面积(β=0.048, P=0.020)、长度(β=0.051, P=0.007)与进展速度呈独立正相关,瘤体曲度(β=-0.005, P=0.034)、血栓面积(β=-0.034, P=0.013)与进展速度呈独立负相关。 结论 AAA患者基线CT特征中瘤体面积、长度、曲度、血栓面积与病变进展显著相关。

Correlation between baseline CT features and progression of abdominal aortic aneurysm in 71 cases

Objective To evaluate the baseline CT features associated with the progression of abdominal aortic aneurysm(AAA)so as to provide a reference for the clinical treatment of AAA. Methods Clinical and imaging data of 83 AAA patients who underwent at least two enhanced CT scans during Jan. 2012 and Dec. 2021 were selected for analysis, with an interval of 3 months or more between the two scans. Baseline CT features such as aneurysm diameter, area, length, curvature, and thrombus area were measured, and the annual rate of AAA progression was calculated based on the aneurysm diameter. Patients with progression were divided into slow progression group(progression rate ≤0.25 cm/y)and rapid progression group(progression rate >0.25 cm/y). Independent samples t-test or Mann-Whitney U nonparametric test was used for comparison between groups; univariate and multivariate linear regression analyses were applied to determine baseline CT characteristics associated with AAA progression. Results Progression was present in 71 patients, including 35 in the slow progression group and 36 in the rapid progression group. The baseline aneurysm length was significantly longer in the rapid progression group than in the slow progression group(P=0.03). Multivariate analysis showed that aneurysm area(β=0.048, P=0.020)and length(β=0.051, P=0.007)were independently and positively correlated with the rate of progression, and aneurysm curvature(β=-0.005, P=0.034)and thrombus area(β=-0.034, P=0.013)were independently and negatively correlated with the rate of progression. Conclusion Among the baseline CT features of AAA patients, aneurysm area, length, curvature, and thrombus area are significantly associated with progression.