Tanaka Hidemasa, Shimada Kenei, Yoshida Ken, Jissho Satoshi, Yoshikawa Junichi, Yoshiyama Minoru
The Division of Cardiovascular Medicine, Osaka Ekisaikai Hospital, 2-1-10 Honden, Nishi-ku, Osaka 550-0022, Japan.
Circ J. 2007 Oct;71(10):1593-8. doi: 10.1253/circj.71.1593.
Recent advancements in 16-slice multidetector-row computed tomography (16-slice MDCT) provide for non-invasive assessment of not only coronary artery disease (CAD), but also myocardial properties and the anatomy of the whole heart. The purpose of the present study was to investigate whether the aortic valve area (AVA) in patients with aortic stenosis (AS) assessed by 16-slice MDCT corresponds to echocardiographic assessment and to evaluate simultaneously the clinical accuracy in detecting CAD with 16-slice MDCT.
The AVA of 29 consecutive AS patients with transthoracic echocardiography (TTE) and 16-slice MDCT were analyzed. The AVA was estimated by means of the continuity equation method in 2-dimensional echocardiography (DE) and the quantitative planimetric method after multi-planar reformation in 16-slice MDCT. Concomitantly, the severity of the coronary artery stenosis was assessed by 16-slice MDCT. In the present study, the AVA assessed by TTE and 16-slice MDCT was 1.34+/-0.32 cm(2) and 1.38+/-0.32 cm(2), respectively. Regression analysis showed that the AVA in patients with AS determined by 16-slice MDCT correlated well with those determined by 2-DE (r=0.96, p<0.001). Significant coronary artery stenosis of more than 50% diameter reduction was present in 48% of the study population.
In patients with AS, the analysis of the severity of the AVA by 16-slice MDCT provides a feasible and accurate estimation with the concomitant evaluation of CAD.
16层多排螺旋计算机断层扫描(16层MDCT)的最新进展不仅能够对冠状动脉疾病(CAD)进行无创评估,还能对心肌特性和整个心脏的解剖结构进行评估。本研究的目的是调查通过16层MDCT评估的主动脉瓣狭窄(AS)患者的主动脉瓣面积(AVA)是否与超声心动图评估结果相符,并同时评估16层MDCT检测CAD的临床准确性。
对29例连续的AS患者进行经胸超声心动图(TTE)和16层MDCT检查,并分析其AVA。在二维超声心动图(DE)中通过连续性方程法估算AVA,在16层MDCT的多平面重建后通过定量平面测量法估算AVA。同时,通过16层MDCT评估冠状动脉狭窄的严重程度。在本研究中,通过TTE和16层MDCT评估的AVA分别为1.34±0.32 cm²和1.38±0.32 cm²。回归分析表明,16层MDCT测定的AS患者的AVA与二维超声心动图测定的AVA相关性良好(r = 0.96,p < 0.001)。48%的研究人群存在直径减少超过50%的显著冠状动脉狭窄。
对于AS患者,通过16层MDCT分析AVA的严重程度可提供一种可行且准确的评估方法,同时可对CAD进行评估。