초록접수 현황
| 20F-134 | 구연 발표 |
Predictable finding to distinguish type A aortic dissection and intramural hematoma at preoperative CT angiography
Suryeun Chung, Yang Hyun Cho, Dong Seop Jeong, Wook Sung Kim, Kiick-Sung
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center
Sungkyunkwan University School of Medicine, Seoul, Korea
Purpose : Aortic dissection with thrombus in false lumen is mimicked intramural hematoma at CT angiography. As some studies reported that medical management is the tolerable result in type A intramural hematoma, it is more important to correct the diagnosis recently. We aimed to investigate predictable finding to distinguish aortic dissection and intramural hematoma at CT scan.
Methods : We studied patients who were diagnosed as type A intramural hematoma by CT scan from 1999 to 2019. These patients were divided into two groups according to the presence of intimal tear in operation. We retrospectively measured thrombus thickness, thrombus/aortic diameter ratio(T/A ratio),compression of true lumen,maximum housefiled unit(HU) at thrombus,lesion circumference and combined pericardial effusion at preoperative CT scan. We performed ROC analysis to determine cut-off value of diagnostic performance.
Results : A total of 97 patients was diagnosed type A intramural hematoma at preoperative CT scan. Among them, 54 patients surgery and 26 patients confirmed intimal tear site at operation.(Dissection group)(26/97,26.8%). The mean of thrombus thickness is higher at aortic dissection (17.6±10.2vs8.2±2.5,p<0.01). From ROC analysis, a cut-off value of 12mm (AUC:0.706,95%CI:0.555-0.842, p<0.01) was best value for detecting dissection. In T/A ratio, 24% were meaningful cut-off value.(AUC:0.696,95%CI:0.533-0.826,p=0.02). The T/A ratio seems to be helpful finding when the thrombus thickness was under the 12mm.(Fig1.) Combined pericardial effusion showed higher in dissection group.(53.8%vs21.4%,p=0.02) Meanwhile, compression of true lumen, HU at thrombus, lesion circumference were not different significantly between groups.
Conclusion : The thickness of thrombus, thrombus/aorta diameter ratio and combined pericardial effusion are useful CT finding to predictive aortic dissection.
Methods : We studied patients who were diagnosed as type A intramural hematoma by CT scan from 1999 to 2019. These patients were divided into two groups according to the presence of intimal tear in operation. We retrospectively measured thrombus thickness, thrombus/aortic diameter ratio(T/A ratio),compression of true lumen,maximum housefiled unit(HU) at thrombus,lesion circumference and combined pericardial effusion at preoperative CT scan. We performed ROC analysis to determine cut-off value of diagnostic performance.
Results : A total of 97 patients was diagnosed type A intramural hematoma at preoperative CT scan. Among them, 54 patients surgery and 26 patients confirmed intimal tear site at operation.(Dissection group)(26/97,26.8%). The mean of thrombus thickness is higher at aortic dissection (17.6±10.2vs8.2±2.5,p<0.01). From ROC analysis, a cut-off value of 12mm (AUC:0.706,95%CI:0.555-0.842, p<0.01) was best value for detecting dissection. In T/A ratio, 24% were meaningful cut-off value.(AUC:0.696,95%CI:0.533-0.826,p=0.02). The T/A ratio seems to be helpful finding when the thrombus thickness was under the 12mm.(Fig1.) Combined pericardial effusion showed higher in dissection group.(53.8%vs21.4%,p=0.02) Meanwhile, compression of true lumen, HU at thrombus, lesion circumference were not different significantly between groups.
Conclusion : The thickness of thrombus, thrombus/aorta diameter ratio and combined pericardial effusion are useful CT finding to predictive aortic dissection.
책임저자: Kiick Sung
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
발표자: Suryeun Chung , E-mail : suryeun.chung@samsung.com