感染性主动脉瘤的CT影像学分析与诊断
Computed tomography analysis and diagnosis of infective native aortic aneurysm
霍正坤 1高培显 2孔祥骞 2周华 2杨乐 2吴学君3
作者信息
- 1. 山东大学齐鲁医学院 山东 济南 250012;山东省立医院血管外科 山东 济南 250021
- 2. 山东第一医科大学附属省立医院血管外科 山东 济南 250021
- 3. 山东大学齐鲁医学院 山东 济南 250012;山东省立医院血管外科 山东 济南 250021;山东第一医科大学附属省立医院血管外科 山东 济南 250021
- 折叠
摘要
目的 通过感染性主动脉瘤(INAA)与非感染性主动脉瘤(NIAA)的 CT特征比较,建立诊断模型,探讨INAA与NIAA的CT影像学差异.方法 选取山东省立医院就诊的INAA患者 87 例(INAA组),应用倾向性评分匹配选取NIAA患者 87 例(NIAA组),对比两组间CT影像学特征,建立列线图影像学诊断模型.结果 INAA组的平均直径较 NIAA 组小(56.0mm vs.60.7mm),差异有统计学意义(P=0.035).INAA 组囊性(52.9%vs.16.1%)、分叶状(40.2%vs.3.4%)动脉瘤较 NIAA 组更常见,管周积气(37.9%vs.0%)、积液(59.8%vs.5.7%)和邻近组织感染(54.0%vs.0%)在NIAA组罕见.瘤壁钙化不能作为INAA的诊断依据(P=0.158).多发动脉瘤在感染与非感染性动脉瘤组间差异无统计学意义(P=0.116).依据囊性、分叶状、积气、积液、附壁血栓CT特征建立列线图诊断模型,可依据CT影像学特征较准确诊断INAA.结论 基于CT表现的列线图诊断模型具有较好的准确度和区分度,瘤体无钙化可能提示动脉瘤快速进展,多发性动脉瘤能否作为INAA提示特征还有待进一步观察.
Abstract
Objective By comparing the CT features of infective aortic aneurysm(INAA)and non-infective aortic aneu-rysm(NIAA)to build a nomogram diagnostic model so as to determine the CT imaging differences between INAA and NIAA.Methods 87 patients with INAA and 87 patients with NIAA were selected by propensity-scoring match method.The clinical data were reported and the difference of CT characteristics between two groups was compared.The diagnostic model was built in nomogram.Results INAA had smaller diameter compared to the NIAA(56.0mm).Saccular(52.9%versus 16.1%),multilobu-lar(40.2%versus 3.4%)aneurysm were more common in INAA.Periaortic gas(37.9%versus 0%),fluid(59.8%versus 5.7%)and adjacent infection(54.0%versus 0%)were the characteristic imaging features of INAA.A nomogram model based on fea-tures as saccular,multilobular,periaortic gas,fluid and mural thrombus was constructed,which can diagnose INAA with high accuracy.Conclusions The nomogram model has a good sensitivity and specificity.Rapid progression can be indicated by the absence of calcification.The indication of the diagnosis of INAA by multiple aneurysms needs further discussion.
关键词
感染性主动脉瘤/动脉瘤/列线图模型/体层摄影术,X线计算机Key words
Infective native aortic aneurysm/Aneurysm/Nomogram model/Tomography,X-ray computed引用本文复制引用
基金项目
国家自然科学基金面上项目(82070480)
出版年
2024
NETL
NSTL
万方数据