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彩超与计算机断层扫描测量腹主动脉瘤直径比较的初步研究
Comparison with Computed Tomography of Various Ultrasonography Methods for Measuring the Abdominal Aortic Aneurysm - A Pilot Study

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DOI:
作者:
李炜淼, 陈斌, 郭大乔, 董智慧, 竺挺
Liweimiao,Chenbin,Guodaqiao,Dongzhihui,Zhu ting
作者单位:
复旦大学附属中山医院血管外科研究所
Institute of Vascular Surgery, Zhongshan Hospital, Fudan University
关键词:
彩超，计算机断层扫描，腹主动脉瘤，主动脉直径
摘要:
目的：使用不同的彩超测量方法与CTA测量的腹主动脉瘤直径进行比较，评估两两之间的相关性与一致性，得到具有临床意义的最优测量方法。 方法：2010年4月至10月共收住入院70位初诊腹主动脉瘤患者，对腹主动脉最大径分别进行计算机断层扫描血管造影（CTA）与彩超的测量。彩超的测量方法包括前后位内膜-内膜（DUAP_i）、前后位外膜-外膜（DUAP_a）、横径（DU_trans）及任意方向上的最大径（DU_max）。所得结果分别于CTA结果（CT_max）进行比较，使用线性回归方法评估相关性，根据Bland-Altman法评估不同方法间的一致性，结果使用均数表示。临床上将±5mm作为可接受的误差标准。 结果：最后入组的共有50对数据，CT_max与DUAP_i、DUAP_a、DU_trans以及DU_max的相关性分析中，相关系数分别为0.957、0.960、0.960和0.988（P<0.001）；Bland-Altman法显示4组差值均值分别为5.82±8.05mm，2.80±7.66mm，4.68±7.66mm和0.71±4.22mm，只有DU_max显示了较好的一致性。 结论：各种方法的彩超结果与CTA测量腹主动脉瘤大小具有很高的相关性，但其中只有任意方向上最大径与其具有良好的一致性，因此，使用彩超代替CTA是可行的，但是测量必须符合标准，避免在临床工作中出现误诊。
Objective: This study is designed to assess the agreement of various ultrasonography methods for measuring the abdominal aortic aneurysm with computed tomography. Methods: From April 2010 to October 2010, 70 patients were diagnosed as abdominal aortic aneurysm at our center. All Patients underwent Computed Tomography Angiography (CTA) and/or Color Doppler Ultrasonography (CDU) imaging before and after endovascular repair. Maximal aortic diameter was recorded from intimal to intimal in the anteroposterior plane (DUAP_i), adventitia to adventitia in the anteroposterior plane (DUAP_a), transverse plane (DU_trans) and maximal diameter at any direction (DU_max). The CDU data were compared with maximal diameter obtained by CTA (CT_max). Correlation was assessed with linear regression analysis. Agreement between different measurements was evaluated according to the principles of Bland-Altman plots, and results were repored as mean ± 2SD. When limits of agreement were between -5mm and 5mm, it was regarded as the good agreement. Results: 50 pairs of data were finally included. The correlation coefficients between CTA and the four CDU methods (DUAP_i, DUAP_a, DU_trans, DU_max) were 0.957, 0.960, 0.960 and 0.988, respectively with P<0.001. In Bland-Altman plots, the mean differences between the four pairs were 5.82±8.05mm, 2.80±7.66mm, 4.68±7.66mm and 0.71±4.22mm, respectively, indicating only DU_max was in good agreement with CT_max measurement. Conclusion: All CDU measurements correlate well with CT measurement, but only DU_max is in good agreement with CT. Thus, a measuring standard should be well established to avoid misleading in the clinical diagnosis.

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