In:
European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), Vol. 62, No. 3 ( 2022-08-03)
Abstract:
OBJECTIVES Our goal was to investigate the accuracy of the two-dimensional and three-dimensional computed tomography imaging features in predicting the progression of acute uncomplicated type B aortic intramural haematoma (IMH). METHODS This study retrospectively screened 140 patients diagnosed with acute uncomplicated type B IMH in our institution from January 2015 to December 2020. Patients were classified as exhibiting progression (aortic dissection, aortic rupture, aneurysm formation, ulcer-like projection depth & gt;10 mm or & gt;10% increase in the initial thickness of the aortic wall) and regression (completely or partially reabsorbed haematoma) based on follow-up computed tomography. RESULTS During the 11.4-month follow-up [interquartile range (IQR), 2.6–17.8], 55 patients had haematoma progression. The progression group had higher haematoma volume (HV) and total lesion volume [94.8 (IQR, 80.0–108.2) cm3 vs 40.3 (IQR, 30.8–57.9) cm3; 278.0 (IQR, 238.6–369.3) cm3 vs 197.3 (IQR, 152.8–235.9) cm3, both P & lt; 0.001) and longer lesion length [43.2 (IQR, 37.5–46.7) cm vs 30.4 (IQR, 28.1–37.6) cm, P & lt; 0.001)] than the regression group. According to the area under the curve, HV & gt; 66 cm3 is the greatest risk factor for haematoma progression. In multivariable analysis, HV was a powerful independent predictive factor for type B IMH progression, with a hazard ratio of 17.9 (95% confidence interval, 5.5–58.7; P & lt; 0.001). CONCLUSIONS Volumetric parameters may help to predict disease progression more precisely for patients with acute uncomplicated type B IMH compared to standard axial measurements, which might optimize the initial treatment and follow-up protocol.
Type of Medium:
Online Resource
ISSN:
1873-734X
DOI:
10.1093/ejcts/ezac160
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2022
detail.hit.zdb_id:
1500330-9
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