Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea.
Int J Cardiovasc Imaging. 2011 Dec;27 Suppl 1:61-71. doi: 10.1007/s10554-011-9956-5. Epub 2011 Oct 19.
We aimed to evaluate the diagnostic performance of dual-source computed tomography coronary angiography (DSCT-CA) in the measurement of the ascending aorta (AA) diameter and compare the AA diameter in patients with severe bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) stenosis. Eighty-eight consecutive patients (50 men, mean age 60.3 ± 13 year) with severe aortic stenosis (AS) underwent DSCT-CA before aortic valve surgery. Seventy-four of the 88 patients underwent cardiovascular magnetic resonance (CMR). The internal diameter of AA was measured from early-systole with DSCT-CA and CMR by 2 radiologists independently at 4 levels (aortic annulus, sinuses of Valsalva, sinotubular junction, and tubular portion at the right pulmonary artery). The patients were divided in to 2 groups (BAV [n = 53]; TAV [n = 35]) according to operative findings. Patients with BAV were significantly younger than those with TAV (P = 0.0035). Inter-observer agreement of AA diameters at 4 levels with DSCT-CA and CMR was excellent (intraclass correlation coefficient = 0.89-0.97). Also, the DSCT-CA and CMR measurements of the AA diameter strongly correlated (r = 0.871-0.976). Mean diameter of the AA by DSCT-CA was significantly larger in patients with BAV (34.4 ± 8.2 mm) as compared to those with TAV (30.6 ± 5.5 mm). The diameters at the sinuses of Valsalva, sinotubular junction, and tubular portion were significantly larger in BAV than in TAV. Twenty-two of 53 (41.5%) patients with BAV and 2 of 35 (5.7%) patients with TAV had AA dilatation > 45 mm. DSCT-CA allows accurate assessment of the AA diameters in patients with severe AS. Patients with severe BAV stenosis had larger AA diameters and higher prevalence of AA dilatation > 45 mm as compared to those with severe TAV stenosis.
我们旨在评估双源 CT 冠状动脉成像(DSCT-CA)在测量升主动脉(AA)直径方面的诊断性能,并比较重度二叶式主动脉瓣(BAV)和三叶式主动脉瓣(TAV)狭窄患者的 AA 直径。88 例连续重度主动脉瓣狭窄(AS)患者在主动脉瓣手术前接受 DSCT-CA。88 例患者中有 74 例行心血管磁共振(CMR)检查。使用 DSCT-CA 和 CMR 由 2 名放射科医生独立在 4 个水平(主动脉瓣环、瓦尔萨尔瓦窦、窦管交界处和右肺动脉管段)测量 AA 的内径。根据手术结果,患者分为 2 组(BAV [n = 53];TAV [n = 35])。BAV 患者明显比 TAV 患者年轻(P = 0.0035)。DSCT-CA 和 CMR 测量 4 个水平的 AA 直径的观察者间一致性很好(组内相关系数 = 0.89-0.97)。此外,DSCT-CA 和 CMR 测量的 AA 直径之间存在很强的相关性(r = 0.871-0.976)。与 TAV 患者(30.6 ± 5.5mm)相比,BAV 患者的 AA 直径通过 DSCT-CA 测量明显更大(34.4 ± 8.2mm)。BAV 在窦管交界处和管段的直径明显大于 TAV。53 例 BAV 患者中有 22 例(41.5%)和 35 例 TAV 患者中有 2 例(5.7%)AA 扩张>45mm。DSCT-CA 可准确评估重度 AS 患者的 AA 直径。与重度 TAV 狭窄患者相比,重度 BAV 狭窄患者的 AA 直径更大,AA 扩张>45mm 的患病率更高。
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