Packer Douglas L, Johnson Susan B, Kolasa Mark W, Bunch Thomas J, Henz Benhur D, Okumura Yasuo
Cardiac Translational Electrophysiology Laboratory, Saint Marys Hospital Complex, Mayo Clinic and Foundation, 2-416 Alfred Building, Rochester, MN 55902, USA.
Europace. 2008 Nov;10 Suppl 3:iii35-41. doi: 10.1093/europace/eun231.
Surrogate electro-anatomic-derived geometries are used as the three-dimensional (3D) basis for mapping of cardiac arrhythmias. While merged computed tomography (CT) imaging may provide stellar pulmonary vein (PV) and left atrial (LA) anatomy, the applied scans must be obtained prior to ablation, and may not reflect physiologic conditions at the time of intervention. Patient-specific, ultrasound-derived 3D imaging has been developed as an alternative basis for new generation electro-anatomic mapping. An electro-anatomic sensor positioned at the tip of the phased-array intracardiac ultrasound catheter, provides the means to specify both location and orientation of each image as the 'context' for creating the 3D volumes for co-registration with electro-anatomic mapping. Specific anatomic details such as the pulmonary veins, membranous fossa, papillary muscles, or valve structures derived from real-time imaging can also be integrated into each segmented volume. This presentation reviews the basis and methods for this novel multi-modality image fusion for the creation of robust, nearly real-time anatomic images for guiding electro-anatomic mapping and ablation without requiring pre-acquired CT image sets, with accompanying limitations.
替代的基于电解剖学得出的几何形状被用作心律失常标测的三维（3D）基础。虽然合并的计算机断层扫描（CT）成像可能能提供出色的肺静脉（PV）和左心房（LA）解剖结构，但所应用的扫描必须在消融之前进行，且可能无法反映干预时的生理状况。特定患者的、基于超声的3D成像已被开发出来作为新一代电解剖标测的替代基础。位于相控阵心腔内超声导管尖端的电解剖传感器，提供了指定每个图像的位置和方向的方法，作为创建用于与电解剖标测进行配准的3D容积的“背景”。源自实时成像的特定解剖细节，如肺静脉、膜性窝、乳头肌或瓣膜结构，也可整合到每个分割容积中。本报告回顾了这种新型多模态图像融合的基础和方法，用于创建强大的、近乎实时的解剖图像，以指导电解剖标测和消融，而无需预先获取CT图像集，并附带局限性。
