Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Ann Thorac Surg. 2011 Mar;91(3):716-23. doi: 10.1016/j.athoracsur.2010.09.060.
Accurate aortic root measurements and evaluation of spatial relationships with coronary ostia are crucial in preoperative transcatheter aortic valve implantation assessments. Standardization of measurements may increase intraobserver and interobserver reproducibility to promote procedural success rate and reduce the frequency of procedurally related complications. This study evaluated the accuracy and reproducibility of a novel automated multidetector row computed tomography (MDCT) imaging postprocessing software, 3mensio Valves (version 4.1.sp1, Medical Imaging BV, Bilthoven, The Netherlands), in the assessment of patients with severe aortic stenosis candidates for transcatheter aortic valve implantation.
Ninety patients with aortic valve disease were evaluated with 64-row and 320-row MDCT. Aortic valve annular size, aortic root dimensions, and height of the coronary ostia relative to the aortic valve annular plane were measured with the 3mensio Valves software. The measurements were compared with those obtained manually by the Vitrea2 software (Vital Images, Minneapolis, MN).
Assessment of aortic valve annulus and aortic root dimensions were feasible in all the patients using the automated 3mensio Valves software. There were excellent agreements with minimal bias between automated and manual MDCT measurements as demonstrated by Bland-Altman analysis and intraclass correlation coefficients ranging from 0.97 to 0.99. The automated 3mensio Valves software had better interobserver reproducibility and required less image postprocessing time than manual assessment.
Novel automated MDCT postprocessing imaging software (3mensio Valves) permits reliable, reproducible, and automated assessments of the aortic root dimensions and spatial relations with the surrounding structures. This has important clinical implications for preoperative assessments of patients undergoing transcatheter aortic valve implantation.
在经导管主动脉瓣植入术术前评估中，准确测量主动脉根部并评估其与冠状动脉开口的空间关系至关重要。测量的标准化可能会提高观察者内和观察者间的可重复性，从而提高手术成功率并降低与程序相关的并发症的发生率。本研究评估了一种新型的自动多排螺旋 CT（MDCT）成像后处理软件，即 3mensio Valves（版本 4.1.sp1，Medical Imaging BV，Bilthoven，荷兰）在评估患有严重主动脉瓣狭窄并适合行经导管主动脉瓣植入术患者时的准确性和可重复性。
90 例主动脉瓣疾病患者接受了 64 排和 320 排 MDCT 检查。使用 3mensio Valves 软件测量主动脉瓣环大小、主动脉根部尺寸以及冠状动脉开口相对于主动脉瓣环平面的高度。将这些测量值与使用 Vitrea2 软件（Vital Images，明尼苏达州明尼阿波利斯）手动获得的测量值进行比较。
使用自动 3mensio Valves 软件可以对所有患者的主动脉瓣环和主动脉根部尺寸进行评估。 Bland-Altman 分析和 0.97 至 0.99 的组内相关系数显示，自动和手动 MDCT 测量之间存在极好的一致性，且最小偏差。与手动评估相比，自动 3mensio Valves 软件具有更好的观察者间可重复性，并且需要的图像后处理时间更少。
新型自动 MDCT 后处理成像软件（3mensio Valves）可实现对主动脉根部尺寸及其与周围结构的空间关系的可靠、可重复和自动评估。这对接受经导管主动脉瓣植入术的患者的术前评估具有重要的临床意义。
