Intra-luminal thrombus has been suggested to play a role in the progression of abdominal aortic aneurysm (AAA). The aims of this study were twofold. Firstly, to assess the reproducibility of a computer tomography (CT)-based technique for measurement of aortic thrombus volume. Secondly, to examine the determinants of infrarenal aortic thrombus volume in a cohort of patients with aortic dilatation. A consecutive series of 75 patients assessed by CT angiography with maximum aortic diameter > or = 25 mm were recruited. Intra-luminal thrombus volume was measured by a semi-automated workstation protocol based on a previously defined technique to quantitate aortic calcification. Intra- and inter-observer reproducibility were assessed using correlation coefficients, coefficient of variation and Bland-Altman plots. Infrarenal aortic thrombus volume percentage was related to clinical, anatomical and blood characteristics of the patients using univariate and multivariate tests. Infrarenal aortic thrombus volume was related to the severity of aortic dilatation assessed by total aortic volume (r = 0.87, P < 0.0001) or maximum aortic diameter (r = 0.74, P < 0.0001). We therefore examined the clinical determinates of aortic thrombus expressed as a percentage of total aortic volume. Aortic thrombus percentage was negatively correlated with serum high density lipoprotein (HDL, r = -0.31). By ordinal multiple logistic regression analysis serum HDL below median (< or = 1.2 mM: ) was associated with aortic thrombus percentage in the upper quartile adjusting for other risk factors (odds ratio 5.3, 95% CI 1.1-25.0). Infrarenal aortic thrombus volume can be measured reproducibly on CT. Serum HDL, which can be therapeutically raised, may play a role in discouraging aortic thrombus accumulation with implications in terms of delaying progression of AAA.

译文

腔内血栓已被认为在腹主动脉瘤 (AAA) 的进展中起作用。这项研究的目的是双重的。首先,评估基于计算机断层扫描 (CT) 的主动脉血栓体积测量技术的可重复性。其次,在一组主动脉扩张患者中检查肾下主动脉血栓体积的决定因素。连续招募了75例通过CT血管造影评估的主动脉最大直径> 或 = 25毫米的患者。腔内血栓体积是通过基于先前定义的定量技术的半自动工作站协议测量的,以定量主动脉钙化。使用相关系数,变异系数和Bland-Altman图评估观察者内和观察者间的可重复性。使用单变量和多变量测试,肾下主动脉血栓体积百分比与患者的临床,解剖和血液特征有关。肾下主动脉血栓体积与主动脉总体积 (r = 0.87,P <0.0001) 或主动脉最大直径 (r = 0.74,P <0.0001) 评估的主动脉扩张严重程度有关。因此,我们检查了以总主动脉体积百分比表示的主动脉血栓的临床决定。主动脉血栓百分比与血清高密度脂蛋白 (HDL,r = -0.31) 呈负相关。通过有序多元逻辑回归分析,血清HDL低于中位数 (<或 = 1.2 mM:) 与调整其他危险因素的上四分位数的主动脉血栓百分比相关 (优势比5.3,95% CI 1.1-25.0)。可以在CT上重复测量肾下主动脉血栓体积。可以在治疗上升高的血清HDL可能在阻止主动脉血栓积聚方面发挥作用,从而延迟AAA的进展。

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