心脏瓣膜病胸主动脉CT重建特征及其临床意义

  目的  观察心脏瓣膜病胸主动脉CT重建特征及其临床意义。  方法  选取2018年10月~2021年12月北碚区中医医院放射科收治的300例患者作为研究对象，将95例心脏瓣膜病患者纳入病例组，205例非心脏瓣膜病变的普通患者纳入对照组，均行CT增强扫描和三维重建，比较两组的临床一般资料和CT测量值(包括胸主动脉长度、主动脉峡部直径和膈肌层面主动脉直径)，采用Logistic分析患者胸主动脉长度的影响因素。  结果  病例组患者的胸主动脉长度、主动脉峡部直径和膈肌层面主动脉直径均高于对照组，差异有统计学意义(P < 0.05)，心脏瓣膜病变患者主要CT特征为主动脉扩张，瓣膜增厚; 不同年龄、性别、高血压和主动脉壁斑块、心脏瓣膜病的患者胸主动脉长度比较，差异有统计学意义(P < 0.05);年龄(OR=2.121)、主动脉壁斑块(OR=2.234)、心脏瓣膜病(OR=1.964)是影响患者胸主动脉长度的因素，差异有统计学意义(P < 0.05)。  结论  心脏瓣膜病患者胸主动脉增长、主动脉峡部及膈肌层面增长增宽，同时胸主动脉长度受年龄、主动脉壁斑块和心脏瓣膜病的影响，了解其形态特征，对于主动脉手术治疗具有一定的指导意义。 

Characteristics and clinical significance of thoracic aorta ct reconstruction in valvular heart disease

  Objective  To observe the characteristics and clinical significance of thoracic aorta CT reconstruction in valvular heart disease.  Methods  A total of 300 patients admitted to radiology department of Beibei District Hospital of Traditional Chinese Medicine were enrolled from October 2018 to December 2021, including 95 cases with valvular heart disease in case group and other 205 ordinary cases in control group. All patients underwent CT scan and multi-phase reconstruction. The general clinical data and CT measurement data (length of thoracic aorta, diameter of aortic isthmus, aortic diameter at diaphragm level) were compared between the two groups. The influencing factors of thoracic aorta length were analyzed by Logistics analysis.  Results  The length of thoracic aorta, diameter of aortic isthmus and aortic diameter at diaphragm level in cases were longer than those in control group (P < 0.05). The main CT characteristics in patients with heart valve disease included aortic dilatation and valve thickening. The differences in length of thoracic aorta among patients with different age, genders, hypertension, aortic wall plaques and valvular heart diseases were statistically significant (P < 0.05). Age (OR=2.121), aortic wall plaque (OR= 2.234) and valvular heart disease(OR=1.964) were influencing factors of thoracic aorta length.  Conclusion  The thoracic aorta is increased, aortic isthmus and aortic diameter at diaphragm level are thickened in patients with valvular heart disease. The length of thoracic aorta is affected by age, aortic wall plaques and heart valve disease. Understanding the morphological characteristics has certain guiding significance for aortic surgical treatment.