Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim-University of Heidelberg, Baden-Württemberg, Germany.
AJR Am J Roentgenol. 2012 Apr;198(4):939-45. doi: 10.2214/AJR.11.7231.
The purpose of this article is to assess aortic root and iliofemoral vessel anatomy and the frequency of clinically significant incidental findings on aortoiliac CT angiography (CTA) performed for planning of transcutaneous aortic valve implantation.
Aortoiliac CTA studies of 207 patients scheduled for transcutaneous aortic valve implantation were analyzed. Anatomic dimensions relevant to the interventional procedure, including diameter of the aortic annulus and sinus of Valsalva, distance between aortic annulus and coronary ostia, coronary leaflet length, left ventricular outflow tract diameter, and vessel diameter of iliac arteries, were analyzed. Clinically significant incidental findings were recorded.
The mean (± SD) maximum and minimum diameters of the aortic annulus were 29 ± 3.9 mm and 23.5 ± 4.1 mm, respectively. The mean distances between aortic annulus and the ostium of the left and right coronary artery were 13.5 ± 3.2 mm and 14.8 ± 3.9 mm, respectively. The mean maximum and minimum diameters of the left ventricular outflow tract were 27 ± 4 mm and 1.9 ± 4 mm, respectively. The mean diameter of the sinus of Valsalva was 33.4 ± 5.1 mm. The mean diameters of the right and left external iliac artery were 8 ± 1 and 8 ± 2 mm, respectively. Almost half the patients (101/207) had clinically significant incidental findings, including noncalcified pulmonary nodules larger than 8 mm (n = 7), pulmonary embolism (n = 3), or aortic aneurysm (n = 12).
Aortoiliac CTA provides relevant information on aortic root and iliofemoral vessel anatomy for preinterventional planning. CTA reveals clinically significant incidental findings in a high number of patients considered for transcutaneous aortic valve implantation, which may have a significant impact on patient selection.
本文旨在评估经皮主动脉瓣植入术规划中行主动脉根部和髂股血管 CT 血管造影（CTA）的主动脉根部和髂股血管解剖结构以及临床显著偶然发现的频率。
对 207 例行经皮主动脉瓣植入术的患者的主动脉根部 CTA 研究进行了分析。分析了与介入程序相关的解剖学尺寸，包括主动脉瓣环和主动脉窦直径、主动脉瓣环与冠状动脉开口之间的距离、冠状动脉瓣叶长度、左心室流出道直径和髂动脉直径。记录了临床显著的偶然发现。
主动脉瓣环的最大（±SD）和最小直径分别为 29 ± 3.9mm 和 23.5 ± 4.1mm。主动脉瓣环与左冠状动脉和右冠状动脉开口之间的平均距离分别为 13.5 ± 3.2mm 和 14.8 ± 3.9mm。左心室流出道的最大和最小直径分别为 27 ± 4mm 和 1.9 ± 4mm。主动脉窦的平均直径为 33.4 ± 5.1mm。右髂外动脉和左髂外动脉的平均直径分别为 8 ± 1mm 和 8 ± 2mm。近一半的患者（207 例中有 101 例）存在临床显著的偶然发现，包括大于 8mm 的非钙化性肺结节（n=7）、肺栓塞（n=3）或主动脉瘤（n=12）。
主动脉根部和髂股血管 CTA 为术前计划提供了主动脉根部和髂股血管解剖结构的相关信息。CTA 在考虑行经皮主动脉瓣植入术的患者中揭示了大量具有临床显著意义的偶然发现，这可能对患者选择产生重大影响。
