Department of Cardiology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Europace. 2010 Jan;12(1):45-51. doi: 10.1093/europace/eup371.
To evaluate the feasibility of integrating three-dimensional images created by intra-procedural cone-beam computed tomography (CBCT) into three-dimensional electroanatomical maps (EAM) and compare its accuracy with that of pre-procedural multi-slice CT (MSCT).
In 24 patients with drug-refractory atrial fibrillation (AF), atriography using CBCT with pulmonary arterial contrast injection was performed at the beginning of the AF ablation procedure. Intra-procedural CBCT images and pre-procedural MSCT images were individually imported into the EAM system and compared their integration accuracy (point-to-surface distance) of each image and EAM just before ablation. The CBCT images were assessed qualitatively and quantitatively in comparison with MSCT images. All CBCT images were graded as optimal or useful in delineating the left atrium-pulmonary vein anatomy and were successfully integrated with the EAM. Overall, integration accuracy was similar for CBCT and MSCT. However, in 11 patients, the MSCT was performed 5 or more days prior to EAM, resulting in significantly shorter surface-to-point distance in CBCT than that in MSCT (P = 0.047). Radiation exposure with CBCT was significantly reduced compared with MSCT (P < 0.001).
It is feasible to integrate CBCT image into EAM, and the integration is relatively accurate. Intra-procedural atriography by CBCT may replace pre-procedural MSCT as the imaging source for image integration.
评估将术中锥形束 CT（CBCT）生成的三维图像与三维电解剖图（EAM）融合的可行性，并比较其与术前多层 CT（MSCT）的准确性。
在 24 例药物难治性心房颤动（AF）患者中，在 AF 消融术开始时使用带肺动脉对比剂注射的 CBCT 进行心导管检查。术中 CBCT 图像和术前 MSCT 图像分别导入 EAM 系统，并比较其各自与消融前 EAM 的融合精度（点到面距离）。对 CBCT 图像进行定性和定量评估，并与 MSCT 图像进行比较。所有 CBCT 图像均被评为可优化或有助于左心房-肺静脉解剖的勾画，并成功与 EAM 融合。总体而言，CBCT 和 MSCT 的融合精度相似。然而，在 11 例患者中，MSCT 在 EAM 前 5 天或更长时间进行，导致 CBCT 的面到点距离明显短于 MSCT（P = 0.047）。与 MSCT 相比，CBCT 的辐射暴露明显减少（P < 0.001）。
将 CBCT 图像集成到 EAM 中是可行的，并且融合相对准确。术中 CBCT 心导管检查可以替代术前 MSCT 作为图像融合的成像源。
