Division of Cardiology, Columbia University Medical Center/New York Presbyterian Hospital, 177 Fort Washington Avenue, New York, NY, 10032, USA.
Curr Cardiol Rep. 2019 Jul 19;21(8):84. doi: 10.1007/s11886-019-1172-2.
Multimodality imaging is integral for diagnosis, procedural guidance, and follow-up of patients undergoing transcatheter aortic valve replacement (TAVR). In this review, we provide an overview of the role of each imaging modality and highlight technical considerations and pitfalls. We also address current controversies and new developments in the field.
Echocardiography remains the primary imaging modality for diagnosis of aortic stenosis and intraprocedural guidance for TAVR, but computed tomography (CT) imaging has supplanted echocardiography for annular sizing and access site evaluation. Magnetic resonance imaging (MRI) shows promise in targeted patient populations. Refined parameters and guidelines for valve sizing and paravalvular regurgitation have sought to standardize these complex assessments. Multimodality imaging remains critical to the success of TAVR, but its role has evolved over time. Understanding the applications, strengths, and limitations of each imaging modality is a crucial skill for the modern structural imager.
多模态影像学对于经导管主动脉瓣置换术（TAVR）患者的诊断、手术指导和随访至关重要。在这篇综述中，我们概述了每种影像学方式的作用，并强调了技术要点和潜在问题。我们还讨论了该领域目前的争议和新进展。
超声心动图仍然是主动脉瓣狭窄的主要诊断影像学方式，也是 TAVR 的术中指导方式，但计算机断层扫描（CT）成像已取代超声心动图用于瓣环大小和入路部位评估。磁共振成像（MRI）在特定患者人群中显示出应用前景。为了规范这些复杂的评估，已经提出了细化的瓣膜大小和瓣周漏的参数和指南。多模态影像学仍然是 TAVR 成功的关键，但它的作用随着时间的推移而演变。了解每种影像学方式的应用、优势和局限性是现代结构性成像医师的关键技能。
