Primary Research On Observation Of Abdominal Aortic Aneurysm With Color Kenesis And Integreted Backscatter

Objective:Try to use color kinesis(CK) to observe the movenent of AAA'wall and Integrated backscatter to survey the intraluminal thrombus of AAA, and combine with some main factors of haemodynamics, such as arterial pressure, wall circumferential tension, wall circumferential stress, blood flow and shear stress, to identify the effect of these factors on pathogenesis of abdominal aortic aneurysms and do some groundwork on prediction of rupture of AAA more accurately. Methods :1. Twenty young men (mean age 24±2.3y,normal group,N), twenty old men(mean age 65±3.4y,old group,O) and ten patients(mean age 65±5.2y,aneurysm group, A) with infrarenal abdominal aorta aneurysm was involved. The wall movement of aorta or AAA was observed and analyzed by color kinesis and " ICKTM Quantitative Analysis System" 2. Intraluminal thrombus in 15 cases with AAA were observed with IBS tech by philips Sonos 5500 sonograph. The IBS value of thrombus were record. The intraluminal thrombus was took in the operation and dyed with Gram and HE. 3.The blood streams and velocity in 10 normal men and the 15 patients with abdominal aortic aneurysm were measured by Doppler ultrasound. four planes was selected in normal aorta: 1cm blow renal artery, middle of infrarenal abdominal aorta, 1cm above bifurcation of abdominal aorta and commom iliac artery and the velocity of blood of those plane was record. Five planes was selected in AAA (entrance, proximal section, central section, distal section and outlet of the aneurysm) and condition of blood stream was record. The velocity at different intervals to the arterial wall were record in 3 AAA. 4. The systolic, diastolic and mean blood pressure of 10 healthy person and 10 patients with infrarenal aortic aneurysms were recorded endoluminally at different plane(thoracic, suprarenal, infrarenal aorta, common iliac artery in healthy person. thoracic, suprarenal aorta, common iliac artery and entrance, body, exit of aneurysms in patients with IAAA). The aneurysms'diameter and length were measured by MRA or CTA, and the pressure wave was recorded by traumatic method. 5. The systolic, diastolic and mean blood pressure were recorded endoluminally at thoracic, suprarenal, infrarenal aorta, common iliac artery in 20 healthy person, and at thoracic, suprarenal aorta, common iliac artery and entrance, body, exit of aneurysms in 10 AAA patients. In healthy person and patients, the radius of vessel and the thickness of vascular wall were measured by MRI scanning. The wall circumferential tension and stress were calculated. 6. The wall tissue of 20 AAA patients and arterious wall tissue of infrarenal aortic of 7 normal man was get and dyed with HE and TUNEL. The structure of tissue and distribution of apoptosis cell was observed. Result and Conclusion 1. CK and " ICKTM Quantitative Analysis System" was a sensitive method to detect regional wall movement of abdominal aorta and AAA. It can provide more useful information in prediction of AAA rupture. 2. Integrated backscatter, as new ultrasounic technic, it can be used on evaluation the intraluminal thrombus of abdominal aortic aneurysm.3. The blood streams in abdominal aortic aneurysms become more complex and can be influence by diameter and shape of the aneurysms. It may influence expansion and rupture of the aneurysm and genesis of the ILT.4. The increased systolic and mean pressure may be one cause to make infrenal aorta damage and prone to form aneurysms. The higher pressure in AAA would accelerate the development and rupture of aneurysms. The pressure wave in abdominal aortic aneurysm is changing and F wave became more obvious when radius of the abdominal aortic aneurysm is bigger. That may increase the burden of the aneurysms'wall and accelerate the aneurysm to expand and rupture.5. The wall circumferential stress may be one cause that make infrenal aorta damage and be prone to form aneurysms. The wall tension of aneurysms was increased while the radius increasing. It would accelerate the development of aneurysms. The increasing of exit and common iliac artery's wall stress made aneurysms tend to invade distant and common iliac artery. 6. The apoptosis cell was not found in normal artery wall tissue. The purple orchid apoptosis cell was found in wall tissue of AAA and most was observed in media and extima. Probably the SMC apoptosis is the result of inflammation of AAA'wall, but it must be an important factor in genesis, development and rupture of AAA.