Durongpisitkul Kritvikrom, Tang Nah Lee, Soongswang Jarupim, Laohaprasitiporn Duangmanee, Nana Apichart, Kangkagate Charuwan
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2002 Aug;85 Suppl 2:S658-66.
The location, size of the defect and age of the patient are the major determining factors for transcatheter closure of an atrial septal defect (ASD). The precise shape and anatomy surrounding the defect cannot always be understood by the traditional transesophageal (TEE) echocardiographic technique.
The authors compared the measurement of ASD size and atrial septal rim using cardiac Magnetic Resonance Imaging (MRI) and TEE to the balloon sizing technique and device size.
Patients having an ASD which met established criteria were selected for evaluation with cardiac MRI and TEE for a closure procedure. Comparison of the ASD imaging and sizing between the different methods was made.
There were 22 patients who had complete transcatheter closure. The mean age and standard deviation of the patients was 33.2+/-15.1 (8-67) years old. The mean weight of the patients was 51.6+/-13.1 (20-99) kg. The average cardiac MRI measurement of the ASD was 24.9+/-6.4 mm compared to the TEE measurement of 20.8+/-5.5 mm. The transcatheter balloon measurement of the ASD was 25.2+/-6.9 (11-36) mm and the device closure size was 24.8+/-6.6 (11-36) mm. The correlation coefficient of cardiac MRI to device closure size was r = 0.784 (p < 0.001) when compared to TEE measurement to device closure size; r = 0.761 (p = 0.001).
The authors demonstrated the capability of the cardiac MRI in assessment of the ASD morphology and anatomy for transcatheter closure of the ASD with an Amplatzer Septal Occluder. Cardiac MRI can provide information about the type, location, size of the defect and direct visualization of the atrial septum anatomy. This detailed information enabled us to provide a safer, more effective application of the ASD occluder.
房间隔缺损（ASD）经导管封堵术的主要决定因素包括缺损的位置、大小及患者年龄。传统经食管（TEE）超声心动图技术并不总能准确了解缺损周围的精确形状和解剖结构。
作者比较了心脏磁共振成像（MRI）和TEE测量ASD大小及房间隔边缘与球囊扩张测量技术和封堵器大小的差异。
选择符合既定标准的ASD患者，通过心脏MRI和TEE进行评估以确定封堵程序。对不同方法之间的ASD成像和大小测量进行比较。
22例患者成功完成经导管封堵。患者的平均年龄及标准差为33.2±15.1（8 - 67）岁。患者的平均体重为51.6±13.1（20 - 99）kg。ASD的心脏MRI平均测量值为24.9±6.4mm，而TEE测量值为20.8±5.5mm。ASD的经导管球囊测量值为25.2±6.9（11 - 36）mm，封堵器闭合尺寸为24.8±6.6（11 - 36）mm。与TEE测量值和封堵器闭合尺寸相比，心脏MRI与封堵器闭合尺寸的相关系数为r = 0.784（p < 0.001）；r = 0.761（p = 0.001）。
作者证明了心脏MRI在评估ASD形态和解剖结构以使用Amplatzer房间隔封堵器经导管封堵ASD方面的能力。心脏MRI可以提供有关缺损类型、位置、大小以及房间隔解剖结构直接可视化的信息。这些详细信息使我们能够更安全、有效地应用ASD封堵器。
