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应用双源 CT 冠状动脉造影测量重度二叶式和三叶式主动脉瓣狭窄患者的升主动脉直径。

Measurement of the ascending aorta diameter in patients with severe bicuspid and tricuspid aortic valve stenosis using dual-source computed tomography coronary angiography.

机构信息

Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea.

出版信息

Int J Cardiovasc Imaging. 2011 Dec;27 Suppl 1:61-71. doi: 10.1007/s10554-011-9956-5. Epub 2011 Oct 19.


DOI:10.1007/s10554-011-9956-5
PMID:22009020
Abstract

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.

摘要

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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本文引用的文献

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Eur Radiol. 2008-3

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