Cardiac Investigations Unit, The Prince Charles Hospital, Rode Road, Chermside, QLD, 4032, Australia,
Int J Cardiovasc Imaging. 2013 Oct;29(7):1537-45. doi: 10.1007/s10554-013-0221-y. Epub 2013 Aug 8.
Adequate vascular access for femoral trans-catheter aortic valve replacement is fundamental to the success of the procedure. Assessment of vascular calibre, tortuosity and calcification is performed by angiography and multi-slice computed tomography (MSCT). Can DynaCT provide the same information as MSCT? 15 Patients underwent MSCT, angiography and DynaCT. Vessel diameter measurements were taken in three positions of the left and right ilio-femoral arteries. Tortuosity was assessed using an index of the direct distance and the distance taken by the artery between two points. Calcification was assessed in MSCT and DynaCT using a simple scoring system. Concordance correlation coefficient of arterial calibre between angiography and MSCT was 0.96 (95 % CI 0.94-0.97). DynaCT and angiography was 0.94 (95 % CI 0.91-0.96) and Dyna CT and MSCT, 0.95 (95 % CI 0.92-0.97). Bland-Altman tests demonstrate a mean difference between the angiogram and the MSCT of 0.06 mm (+0.97, -1.42), angiogram and DynaCT, 0.13 mm, (+1.00, -0.87), DynaCT and MSCT, 0.2 mm, (+1.15, -0.76). Tortuosity comparisons gave a median tortuosity index for MSCT 1.29 and DynaCT 1.23 (p = 0.472). Calcification comparisons of MSCT and DynaCT using correlation coefficients demonstrate a correlation of 0.245 (p = 0.378). Effective radiation doses were: DynaCT; 3.63 ± 0.65 mSv and angiography; 0.57 ± 0.72 mSv, MSCT; 7.15 ± 2.58 mSv. DynaCT is equal to MSCT and angiography in assessing femoral artery calibre. Like MSCT, it can assess tortuosity and can produce 3D images but is inferior in the assessment of calcification.
股动脉经导管主动脉瓣置换术的充分血管通路是手术成功的基础。血管口径、迂曲和钙化的评估通过血管造影和多层螺旋 CT（MSCT）进行。DynaCT 能否提供与 MSCT 相同的信息？15 例患者接受了 MSCT、血管造影和 DynaCT 检查。在左、右髂股动脉的三个位置测量血管直径。迂曲程度通过两点之间的直接距离和动脉距离的指数来评估。MSCT 和 DynaCT 采用简单评分系统评估钙化。血管造影与 MSCT 之间的动脉口径的一致性相关系数为 0.96（95%CI 0.94-0.97）。DynaCT 和血管造影为 0.94（95%CI 0.91-0.96），DynaCT 和 MSCT 为 0.95（95%CI 0.92-0.97）。Bland-Altman 检验显示，血管造影与 MSCT 之间的平均差异为 0.06 毫米（+0.97，-1.42），血管造影与 DynaCT 之间的平均差异为 0.13 毫米（+1.00，-0.87），DynaCT 与 MSCT 之间的平均差异为 0.2 毫米（+1.15，-0.76）。迂曲度比较显示 MSCT 的中位数迂曲度指数为 1.29，DynaCT 为 1.23（p = 0.472）。MSCT 和 DynaCT 之间的钙化比较用相关系数表示，相关性为 0.245（p = 0.378）。有效辐射剂量为：DynaCT：3.63±0.65 mSv，血管造影：0.57±0.72 mSv，MSCT：7.15±2.58 mSv。DynaCT 在评估股动脉口径方面与 MSCT 和血管造影相同。与 MSCT 一样，它可以评估迂曲度并生成 3D 图像，但在钙化评估方面稍逊一筹。
