CT imaging features and clinical analysis of superior mesenteric artery calcification in elderly patients
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摘要:
目的探讨老年患者肠系膜上动脉（SMA）钙化性病变CT影像学特征，分析其临床特征。 方法回顾性分析2016年6月~ 2020年4月在我院进行SMA CT检查的186例患者，分析患者的一般临床资料，根据是否存在缺血性肠病（IBD）分为IBD组（n=26）与非IBD组（n=160），分析比较两组患者SMA钙化的检出率以及钙化斑块的部位、形态、数目及狭窄程度，探讨SMA钙化的CT影像学特征及与IBD的相关性。 结果IBD组SMA钙化斑块总数高于非IBD组（P < 0.05）；IBD组SMA钙化斑块主要以SMA远段为主，其次是SMA近段，而非IBD组钙化斑块主要以SMA近段、SMA中段，位置分布情况差异有统计学意义（P < 0.05），IBD组SMA斑块的血管夹角低于非IBD组（P < 0.05）；两组开口处狭窄程度比较差异有统计学意义（P < 0.05）；IBD组患者SMA斑块钙化程度与其开口狭窄程度呈正相关（P < 0.05）。 结论老年患者SMA钙化性病变多以远段为主，且患者若同时存在开口处狭窄程度≥25%，提示可能存在IBD。 -
关键词:
- 肠系膜上动脉钙化性病变 /
- CT影像学特征 /
- 临床分析
Abstract:ObjectiveTo explore CT imaging features of superior mesenteric artery (SMA) calcification in elderly patients, and further analyze its clinical features. MethodsA total of 186 patients who had completed SMA CT examination in the hospital between June 2016 and April 2020 were selected as the research subjects, and their general clinical data were retrospectively analyzed. According to the presence or absence of ischemic bowel disease (IBD), the patients were divided into IBD group (n=26) and non-IBD group (n=160). The detection rate of SMA calcification, location, morphology, number and stenosis of calcified plaques were compared between the two groups. CT imaging features of SMA calcification and its correlation with IBD were discussed. ResultsThe number of SMA calcified plaques in IBD group was significantly larger than that in non-IBD group (P < 0.05). SMA calcified plaques in IBD group were mainly located in the distal segment of SMA, followed by the proximal segment, while those in non-IBD group were mainly located in proximal and middle segments of SMA. Differences in location distribution were significant (P < 0.05). Vascular angles of SMA plaques in IBD group were significantly smaller than those in non-IBD group (P < 0.05), and difference between the two groups in opening stenosis was also statistically significant (P < 0.05). The degree of SMA plaque calcification was positively correlated with the degree of opening stenosis in IBD group (P < 0.05). ConclusionSMA calcified lesions in elderly patients are mostly located in distal segment, and opening stenosis ≥25% may indicate the presence of IBD. -
图 1 SMA钙化斑块形态CT表现
A:女性患者, 68岁, CT检查发现SMA近段处存在点状钙化斑块; B:男性患者, 62岁, CT检查发现SMA近段存在条状钙化斑块; C:女性患者, 65岁, CT检查发现SMA中段存在环状钙化斑块.
Figure 1. CT findings of the shape of SMA calcified plaque.
表 1 两组一般资料比较
Table 1. Comparison of general information of two groups (n)
组别 年龄(岁, Mean±SD) 性别(男/女) 冠心病 高血压 高血脂症 IBD组(n=26) 75.41±5.29 14/12 10 15 8 非IBD组(n=160) 75.49±6.22 92/68 61 90 50 t/χ2 0.062 0.122 0.001 0.019 0.002 P 0.951 0.727 0.974 0.891 0.961 
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表 2 两组CA钙化斑块及SMA钙化斑块形态比较
Table 2. Comparison of shape between CA calcified plaque and SMA calcified plaque of two groups (n)
组别 CA钙化斑块 SMA钙化斑块 总数[n (%)] 条形 环状 总数[n (%)] 条形 环状 点状 IBD组(n=26) 22 (84.62) 14 8 16 (61.54) 5 8 3 非IBD组(n=160) 112 (70.00) 72 40 40 (25.00) 24 8 8 χ2 2.372 14.189 P 0.124 0.000
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表 3 SMA钙化斑块的狭窄情况及斑块部位比较
Table 3. Comparison of the stenosis and position of the SMA calcified plaque[n (%)]
组别 部位 血管夹角(°, Mean±SD) SMA近段 SMA中段 SMA远段 SMA末段 IBD组(n=26) 8 (30.77) 2 (7.69) 16 (61.54) 0 (0) 52.69±5.33 非IBD组(n=160) 78 (48.75) 72 (45.00) 10 (6.25) 0 (0) 61.47±6.29 t/χ2 16.310 6.732 P 0.000 0.000
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表 4 两组SMA开口处狭窄程度比较
Table 4. Comparison of stenosis degree of SMA opening of two groups (n)
组别 SMA开口狭窄程度 1级 2级 3级 4级 IBD组(n=26) 6 9 8 3 非IBD组(n=160) 135 19 6 0 Z 51.01 P 0.000
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表 5 SMA斑块钙化程度与其开口狭窄程度的相关性分析
Table 5. Correlation analysis between calcification degree and stenosis of opening of the SMA plaque
SMA斑块钙化程度 SMA开口狭窄程度 1级 2级 3级 4级 1级 3 1 1 0 2级 1 8 1 0 3级 2 0 1 0 4级 0 0 5 3
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