Hemodynamics and compliance of Stanford type B aortic dissection: a phase-contrast MR angiography study

doi:10.3969/j.issn.1006-7795.2013.03.002

Abstract

Abstract:

Objective To evaluate the characteristics of hemodynamics and compliance using phase-contrast magnetic resonance angiography (PC-MRA) in Stanford type B aortic dissection patients.Methods A total of 25 consecutive patients with Stanford type B aortic dissection identified by computed tomography angiography were recruited in this study. All patients underwent PC-MRA before operation. The cross-sectional images of aorta for PC-MRA were acquired at the following 6 locations: 1pulmonary bifurcation;2aortic arch; 32 cm distal to the entry;4diaphragm;51 cm distal to the lower renal artery;6aorta-iliac bifurcation. Mean area, flow characteristics (including mean velocity, mean flow volume, net volume) of true and false lumens within one cardiac cycle were measured by using PC-MRA. The compliances of true and false lumens were also calculated. Paired t-test and Pearson correlation analysis were involved in statistical analysis Results The mean area of true lumen was significantly smaller than that of false lumen at location 3~6 (P<0.05); the mean velocity in true lumen was significantly higher than that in false lumen at 3~6 levels (P=0.000). At location 5、6, the mean flow volume and net volume in true lumen were significantly higher than that in false lumen (P<0.05). At location 3、6, the compliance of true lumen was significantly higher than that of false lumen (P<0.05), and positive correlation were found between them (r=0.667,P=0.001;r=0.545,P=0.019). Conclusion PC-MRA can quantitatively measure flow characteristics and compliance of true and false lumen in Stanford type B aortic dissection. It is important to provide a noninvasive hemodynamic monitoring tool for Stanford type B aortic dissection.

Key words: aortic dissection, magnetic resonance angiography, phase contrast, hemodynamics, compliance

CLC Number:

R554⁺.1

GENG Ji, FAN Zhanming, LI Yu, XIN Haiyan, ZHANG Nan. Hemodynamics and compliance of Stanford type B aortic dissection: a phase-contrast MR angiography study[J]. Journal of Capital Medical University, 2013, 34(3): 333-338.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2013.03.002

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2013/V34/I3/333

References

[1] Khan I A, Nair C K. Clinical, diagnostic, and management perspectives of aortic dissection[J]. Chest, 2002, 122(1):321-328.

[2] Sueyoshi E, Sakamoto I, Hayashi K, et al. Growth rate of aortic diameter in patients with type B aortic dissection during the chronic phase[J]. Circulation, 2004, 110(11):256-261.

[3] Hata M, Sezai A, Niino T. Prognosis for patients with type B acute aortic dissection: risk analysis of early death and requirement for elective surgery[J]. Circ J,2007, 71(8):1279-1282.

[4] S ong J M, Kim S D, Kim J H. Long-term predictors of descending aorta aneurismal change in patients with aortic dissection[J]. J Am Coll Cardiol, 2007, 50(8):799-804.

[5] Park K H, Lim C, Choi J H, et al. Midterm change of descending aortic false lumen after repair of acute type I dissection[J]. Ann Thorac Surg, 2009, 87(1):103-108.

[6] Estrera A L, Miller C C Ⅲ, Safi H J. Outcomes of medical management of acute type B aortic dissection[J]. Circulation, 2006, 114(S1):384-389.

[7] Nienaber C A, Eagle K A. Aortic dissection: new frontiers in diagnosis and management: part I: from etiology to diagnostic strategies[J]. Circulation, 2003,108(5):628-635.

[8] Strotzer M, Aebert H, Lenhart M, et al. Morphology and hemodynamics in dissection of the descending aorta. Assessment with MR Imaging[J]. ACTA Radiologica,2000, 41(16):594-600.

[9] Dake M D, Miller D C, Semba C P. Transluminal placement of endovascular stent-grafts for the treatment of de scending thoracic aortic aneurysms[J]. N Engl J Med, 1994, 331 (26) :1729-1734.

[10] 景在平, 冯翔. 腔内隔绝术治疗主动脉夹层的现今认识[J]. 外科理论与实践, 2004, 9(1):6-8.

[11] Fu W G, Shi Y, Wang Y Q, et al. Endovascular therapy for stanford type B aortic dissection in 102 cases[J]. Asian J Surg, 2005, 28(4):271-276.

[12] Roseborough G, Burke J, Sperry J, et al. Twenty-year experience with acute distal thoracic dissections[J]. J Vasc Surg, 2004, 40(2):235-246.

[13] Suzuki T, Mehta RH, Ince H. Clinical profiles and outcomes of acute type B aortic dissection in the current era: lessons from the International Registry of Aortic Dissection (IRAD)[J]. Circulation, 2003, 108(S1):312-317.

[14] Sueyoshi E, Sakamoto I, Hayashi K, et al. Growth rate of aortic diameter in patients with type B aortic dissection during the chronic phase[J]. Circulation, 2004, 110(11):256-261.

[15] Bernard Y, Zimmermann H, Chocron S,et al. False lumen patency as a predictor of late outcome in aortic dissection[J]. Am J Cardiol, 2001, 87(12):1378-1382.

[16] Akutsu K, Nejimaa J, Kiuchia K, et al. Effects of the patent false lumen on the long-term outcome of type B acute aortic dissection[J]. Eur J Cardio-thorac Surg, 2004, 26(23):359-366.

[17] Kleinstreuer C, Li Z. Analysis and computer program for rupture-risk prediction of abdominal aortic aneurysms[J]. Biomed Eng Online, 2006,5:19.

[18] Li ZY, U-King-Im J, Tang TY, et al. Impact of calcification and intraluminal thrombus on the computed wall stresses of abdominal aortic aneurysm[J]. J Vasc Surg, 2008, 47(5):928-935.

[19] Vorp D A, Mandarino W A, Webster M W,et al. Potential influence of intraluminal thrombus on abdominal aortic aneurysm as assessed by a new non-invasive method[J]. Cardiovasc Surg, 1996, 4(6):732-739.

[20] Markl M, Draney M T. Time-resolved three-dimensional magnetic resonance velocity mapping of aortic flow in healthy volunteers and patients after valve-sparing aortic root replacement[J]. J Thorac Cardiovasc Surg, 2005, 130(2):456-463.

[21] 虞桂平,黄斌.主动脉夹层的治疗进展[J].临床误诊误治,2010,23(8):781-783.

[22] 吴明瑞,叶鸿,陈安清.主动脉夹层的易患因素及误诊原因探析[J].临床误诊误治,2010,23(10):965-967.

[23] 王书箱,石秀彩,王冰,等.主动脉夹层四例临床分析[J].解放军医药杂志,2011,23(S1):22-23.