Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Desk J1-5, Cleveland, OH 44195, USA.
J Cardiovasc Comput Tomogr. 2012 Nov-Dec;6(6):393-8. doi: 10.1016/j.jcct.2012.10.006. Epub 2012 Nov 3.
Transcatheter valve interventions rely on imaging for patient selection, preprocedural planning, and intraprocedural guidance.
We explored the use of prospective electrocardiogram (ECG)-triggered 4-dimensional (4-D) CT imaging in patients evaluated for transcatheter aortic valve replacement (TAVR).
A total of 47 consecutive patients underwent 128-slice dual-source CT with wide-window dose-modulated prospective ECG-triggered, axial acquisition of the aortic root, reconstructed during diastolic and systolic cardiac phases. Image quality was evaluated, aortic root and left ventricular (LV) geometry and function were analyzed, and radiation exposure was estimated.
Image quality was generally good, with 41 of 47 (87%) patients scored as good or excellent. The mean aortic valve area was 0.93 ± 0.24 cm(2). Mean LV ejection fraction was 56.8% ± 16.4%, and mean LV mass was 130.4 ± 43.8 g. The minor diameter of the annulus was larger in systole (systole, 2.29 ± 0.24 cm; diastole, 2.14 ± 0.25 cm; P = 0.006), but the mean and major diameters did not vary significantly between systole and diastole. The mean estimated effective dose was 5.9 ± 2.4 mSv.
Multiphase, prospective ECG-triggered axial image acquisition is a lower dose acquisition technique for 4-D aortic root imaging in patients being considered for TAVR.
经导管瓣膜介入治疗依赖于影像学来进行患者选择、术前规划和术中指导。
我们探讨了在接受经导管主动脉瓣置换术（TAVR）评估的患者中使用前瞻性心电图（ECG）触发的 4 维（4-D）CT 成像的情况。
共 47 例连续患者接受了 128 层双源 CT 检查，采用宽窗剂量调制的前瞻性 ECG 触发、主动脉根部轴位采集，在舒张期和收缩期心脏相位进行重建。评估图像质量，分析主动脉根部和左心室（LV）的几何形状和功能，并估计辐射暴露。
图像质量总体良好，47 例中有 41 例（87%）评分良好或优秀。平均主动脉瓣面积为 0.93 ± 0.24cm²。平均 LV 射血分数为 56.8% ± 16.4%，平均 LV 质量为 130.4 ± 43.8g。瓣环的小直径在收缩期较大（收缩期 2.29 ± 0.24cm；舒张期 2.14 ± 0.25cm；P = 0.006），但平均和大直径在收缩期和舒张期之间无显著差异。平均估计有效剂量为 5.9 ± 2.4mSv。
多相位、前瞻性 ECG 触发的轴向图像采集是 TAVR 评估患者 4-D 主动脉根部成像的低剂量采集技术。
