ABSTRACT
Objective To compare the different features of contrast enhanced ultrasound(CEUS) and CT angiography (CTA) in abdominal aortic remodeling after thoracic endovascular aortic repair (TEVAR)of DeBakey type Ⅲ aortic dissection(AD),and to investigate the application value of CEUS in the follow-up of DeBakey type Ⅲ AD after TEVAR.Methods CEUS was performed in 28 patients with DeBakey type Ⅲ AD after TEVAR,in which 8 cases type Ⅲ a (simple type) were not involved of abdominal aorta,20 cases Ⅲ b(complex type) were involved in the abdominal aorta,all patients were performed CTA examination of aorta.The functional and morphological changes of abdominal aortic remodeling were observed by two methods in DeBakey type Ⅲ AD after TEVAR.Results There was no new rupture of the abdominal aorta in 8 cases type Ⅲ a AD,but 20 cases of type Ⅲ b AD showed the situation of ruptures,thrombosis,trues and falses lumen after 3 months of follow-up.CEUS was less than CTA in detecting the number of ruptures (P＜0.05),CEUS and CTA results were similar in the measurement of true and false lumen diameter (P＞0.05),but CEUS clearly showed the hemodynamic characteristics of abdominal aortic intimal tear,the size and position of rupture,moving blood flow of rupture,and true or false lumen,which provided more accurate data for the long term abdominal aortic remodeling of DeBakey type Ⅲ AD after TEVAR.Conclusions CEUS and aortic CTA can play a complementary role in DeBakey type Ⅲ AD after TEVAR of long-term follow-up,it is worth promoting.
ABSTRACT
Purpose To evaluate the abdominal aortic remodeling in both morphology and hemodynamic changes before and after thoracic endovascular aortic repair (TEVAR) for aortic dissection (AD) of DeBakey type Ⅲ by using color Doppler ultrasound and contrast-enhanced ultrasound,in order to provide a novel imaging method for clinical treatment in addition to aortic computed tomography angiography (CTA).Materials and Methods Thirty patients with complicate AD of Debakey type Ⅲ were recruited.The abdominal vessels of patients were examined by color Doppler and contrast-enhanced ultrasound at different times including before TEVAR operation,and 1 day,1 month after operation.The size of true and false lumen,hemodynamic characteristics,thrombosis in false lumen,distal tear sites and blood supply of vital organs were analyzed combined with CTA results.Results The diameter and maximal blood flow velocity of true lumen at abdominal aorta 1 day,1 month after operation were significantly increased compared with those before operation (P＜0.05),but the diameter and maximal velocity of false lumen after operation were significantly decreased compared with those before operation (P＜0.05).The blood supply of affected organs had no significant difference before and after operation (all P＞0.05).The vessel diameter measurements were similar to those of CTA (P＞0.05).Conclusion Color Doppler imaging combined with contrast-enhanced ultrasound is a simple,reproducible method to evaluate the vascular remodeling in hemodynamics and morphology after TEVAR for complicate AD of DeBakey type Ⅲ,which can overcome the shortage of previous assessment only in morphology.