Basman Craig, Alderwish Edris, Rambhatla Tarak, Vaishnav Aditi, Kronzon Itzhak, Mountantonakis Stavros E
Department of Cardiovascular Medicine, Lenox Hill Hospital, Northwell Health, New York, New York.
Echocardiography. 2018 Oct;35(10):1635-1640. doi: 10.1111/echo.14104. Epub 2018 Jul 25.
Currently, there is no accepted protocol for left atrial appendage (LAA) imaging with intracardiac echocardiography (ICE).
This study aimed to assess the utility of ICE to reliably visualize the entire cavity of the LAA and propose a specific procedural protocol to achieve the above objective.
We created a three-dimensional reconstruction of the LAA, using two-dimensional ICE sections obtained from three different location (the right atrium [RA], right ventricle inflow [RVI], and right ventricular outflow [RVOT]). We then compared the three-dimensional LAA reconstruction by ICE with one obtained by cardiac computed tomography angiography (CCTA) for morphological and volume differences.
Three-dimensional reconstruction with ICE could reliably reproduce the LAA as visualized with CCTA but only when ICE sampling was performed from at least two catheter positions. There was no statistically significant difference between LAA volumes obtained with ICE and CCTA (P = 0.33). The contribution of each anatomical location to the total volume was 17% ± 16.6%, 74% ± 13.3%, and 33% ± 26% for RA, RVI, and RVOT, respectively.
In comparison with CCTA, the LAA can be reliably visualized in its entity by ICE, but only if multiple imaging positions (RA, RV inflow, and RVOT) are used.
目前，对于心腔内超声心动图（ICE）用于左心耳（LAA）成像尚无公认的方案。
本研究旨在评估ICE可靠显示LAA整个腔室的效用，并提出实现上述目标的具体操作方案。
我们利用从三个不同位置（右心房[RA]、右心室流入道[RVI]和右心室流出道[RVOT]）获取的二维ICE切面创建了LAA的三维重建。然后，我们将ICE的三维LAA重建与心脏计算机断层血管造影（CCTA）获得的重建进行形态学和容积差异比较。
ICE三维重建能够可靠地重现CCTA所显示的LAA，但前提是至少从两个导管位置进行ICE采样。ICE和CCTA获得的LAA容积之间无统计学显著差异（P = 0.33）。RA、RVI和RVOT对总体积的贡献分别为17%±16.6%、74%±13.3%和33%±26%。
与CCTA相比，ICE能够可靠地完整显示LAA，但前提是使用多个成像位置（RA、RV流入道和RVOT）。
