Division of Cardiovascular Medicine, Sakurabashi Watanabe Hospital, Osaka, Japan.
Center of Ultrasonic Diagnostics, Okayama University Hospital, Okayama, Japan.
J Cardiol. 2018 Nov;72(5):395-402. doi: 10.1016/j.jjcc.2018.04.015.
Management of adult congenital heart disease (ACHD) patients requires understanding of its complex morphology and functional features. An innovative imaging technique has been developed to display a virtual multi-planar reconstruction obtained from contrast-enhanced multidetector-computed tomography (MDCT) corresponding to the same cross-sectional image from transthoracic echocardiography (TTE). The aim of this study is to assess the usefulness of this imaging technology in ACHD patients.
This study consisted of 46 consecutive patients (30 women; mean age, 52±18 years old) with ACHD who had undergone contrast MDCT. All patients underwent TTE within a week of MDCT. An experienced sonographer who did not know the results of MDCT conducted a diagnosis using TTE and, then, using the new imaging technology. We studied whether this imaging technology provided additional or unexpected findings or makes more accurate diagnosis.
In this imaging technology, MDCT cross-section provides higher-resolution image to the deep compared to corresponding TTE image. Depending on the MDCT section which can be arbitrarily set under the echo guide, we can diagnose unexpected or incremental lesions or more accurately assess the severity of the lesion in 27 patients (59%) compared to TTE study alone. This imaging technology was useful in the following situations: CONCLUSIONS: This integrated imaging technology provides incremental role over TTE in complex anatomy, and allows functional information in ACHD patients.
成人先天性心脏病(ACHD)患者的管理需要了解其复杂的形态和功能特征。已经开发出一种创新的成像技术,可显示与经胸超声心动图(TTE)的相同横截面图像相对应的对比增强多探测器 CT(MDCT)的虚拟多平面重建。本研究的目的是评估该成像技术在 ACHD 患者中的应用价值。
本研究包括 46 例连续的 ACHD 患者(30 名女性;平均年龄 52±18 岁),均接受了对比 MDCT 检查。所有患者均在 MDCT 后一周内接受 TTE 检查。一位不了解 MDCT 结果的经验丰富的超声医师使用 TTE 进行诊断,然后使用新的成像技术进行诊断。我们研究了该成像技术是否提供了额外的或意外的发现或更准确的诊断。
在这项成像技术中,MDCT 横截面提供了比相应的 TTE 图像更高分辨率的深部图像。根据可以在回声引导下任意设置的 MDCT 部分,我们可以在 27 例患者(59%)中诊断出意外或增量病变,或者比单独进行 TTE 研究更准确地评估病变的严重程度。这项成像技术在以下情况下有用:
这种集成的成像技术在复杂解剖结构中提供了比 TTE 更具增量作用,并为 ACHD 患者提供了功能信息。