经导管主动脉瓣置换术前计算机断层血管造影中非心脏检查结果的患病率。
Prevalence of noncardiac findings in computed tomography angiography before transcatheter aortic valve replacement.
作者信息
Staab Wieland, Bergau Leonard, Lotz Joachim, Sohns Christian
机构信息
Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center Göttingen, Robert-Koch-Str. 40, 37099 Göttingen, Germany; DZHK, German Center for Heart Research, Göttingen, Germany.
DZHK, German Center for Heart Research, Göttingen, Germany; Department of Cardiology and Pneumology, Heart Center, University Medical Center Göttingen, Göttingen, Germany.
出版信息
J Cardiovasc Comput Tomogr. 2014 May-Jun;8(3):222-9. doi: 10.1016/j.jcct.2014.03.004. Epub 2014 Apr 25.
OBJECTIVE
This study sought to determine the prevalence of significant and nonsignificant noncardiac findings in patients undergoing preprocedural dual-source CT (DSCT) before transcatheter aortic valve implantation (TAVI).
METHODS
Patients (n = 204; aged, 80.5 ± 5.1 years; 106 men) underwent preprocedural DSCT of the thoracoabdominal aorta and the pelvic arterial vessels. Noncardiac findings were recorded and categorized as nonsignificant (group A), incidental findings requiring follow-up examinations (group B), and significant findings with a demand for clinical treatment (group C).
RESULTS
In 60 of 204 DSCT examinations (29.4%) no noncardiac findings were observed. Of the remaining 144 examinations (70.6%), 260 had noncardiac findings; 35 of 204 patients (17.1%) had a total of 37 clinically significant noncardiac findings. Eight malignancies were detected; 5 of them were incidentally diagnosed on DSCT and changed patient management. A total of 223 nonsignificant findings were observed in 116 of 204 patients (56.9%; group A), the most frequent findings were pleural effusions or colorectal diverticulosis. The prevalence of incidental and significant findings on DSCT before TAVI increased with patient age (r(2) = 0.69; P = .01).
CONCLUSION
Significant noncardiac findings are common in patients referred to routine preprocedural DSCT for planning TAVI (17.1%).
目的
本研究旨在确定经导管主动脉瓣植入术（TAVI）术前接受双源CT（DSCT）检查的患者中，显著和非显著非心脏检查结果的发生率。
方法
患者（n = 204；年龄80.5±5.1岁；男性106例）在术前接受胸主动脉、腹主动脉及盆腔动脉血管的DSCT检查。记录非心脏检查结果并分为非显著（A组）、需要随访检查的偶然发现（B组）以及需要临床治疗的显著发现（C组）。
结果
204例DSCT检查中，60例（29.4%）未观察到非心脏检查结果。其余144例检查（70.6%）中，260例有非心脏检查结果；204例患者中有35例（17.1%）共有37项具有临床意义的非心脏检查结果。检测到8例恶性肿瘤；其中5例在DSCT检查时偶然诊断出，改变了患者的治疗方案。204例患者中有116例（56.9%；A组）共观察到223项非显著检查结果，最常见的是胸腔积液或结肠憩室。TAVI术前DSCT偶然发现和显著发现的发生率随患者年龄增加而升高（r(2)=0.69；P = 0.01）。
结论
在因TAVI计划而接受常规术前DSCT检查的患者中，显著非心脏检查结果很常见（17.1%）。
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