Italiano Gianpiero, Maltagliati Anna, Mantegazza Valentina, Fusini Laura, Mancini Maria Elisabetta, Gasperetti Alessio, Brusoni Denise, Susini Francesca, Formenti Alberto, Pontone Gianluca, Fassini Gaetano, Tondo Claudio, Pepi Mauro
Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
Department of Cardiovascular Sciences and Community Health, University of Milan, 20138 Milan, Italy.
Diagnostics (Basel). 2020 Dec 17;10(12):1103. doi: 10.3390/diagnostics10121103.
Percutaneous left atrial appendage closure (LAAC) requires accurate pre- and intraprocedural measurements, and multimodality imaging is an essential tool for guiding the procedure. Two-dimensional (2D TOE) and three-dimensional (3D TOE) transoesophageal echocardiography, cardiac computed tomography (CCT), and conventional cardiac angiography (CCA) are commonly used to evaluate left atrial appendage (LAA) size. However, standardized approaches in measurement methods by different imaging modalities are lacking. The aims of the study were to evaluate the LAA dimension and morphology in patients undergoing LAAC and to compare data obtained by different imaging modalities: 2D and 3D TOE, CCT, and CCA.
A total of 200 patients (mean age 70 ± 8 years, 128 males) were examined by different imaging techniques (161 2D TOE, 103 3D TOE, 98 CCT, and 200 CCA). Patients underwent preoperative CCT and intraoperative 2D and 3D TOE and CCA.
A significant correlation was found among all measurements obtained by different modalities. In particular, 3D TOE and CCT measurements were highly correlated with an excellent agreement for the landing zone (LZ) dimensions (LZ diameter: r = 0.87; LAA depth: r = 0.91, < 0.001).
Head-to-head comparison among imaging techniques (2D and 3D TOE, CCT, and CCA) showed a good correlation among LZ diameter measurements obtained by different imaging modalities, which is a parameter of paramount importance for the choice of the LAAC device size. LZ diameters and area by 3D TOE had the best correlation with CCT.
经皮左心耳封堵术（LAAC）需要在术前和术中进行准确测量，多模态成像技术是指导该手术的重要工具。二维（2D TOE）和三维（3D TOE）经食管超声心动图、心脏计算机断层扫描（CCT）以及传统心脏血管造影术（CCA）常用于评估左心耳（LAA）大小。然而，不同成像模态的测量方法缺乏标准化。本研究旨在评估接受LAAC治疗患者的LAA尺寸和形态，并比较不同成像模态（2D和3D TOE、CCT和CCA）所获得的数据。
共有200例患者（平均年龄70±8岁，男性128例）接受了不同成像技术检查（161例2D TOE、103例3D TOE、98例CCT和200例CCA）。患者术前接受CCT检查，术中接受2D和3D TOE以及CCA检查。
不同模态所获得的所有测量值之间均存在显著相关性。特别是，3D TOE和CCT测量值高度相关，在着陆区（LZ）尺寸方面一致性极佳（LZ直径：r = 0.87；LAA深度：r = 0.91，P < 0.
成像技术（2D和3D TOE、CCT和CCA）之间的直接比较显示，不同成像模态所获得的LZ直径测量值之间具有良好相关性，这是选择LAAC装置尺寸的一个至关重要的参数。3D TOE测量的LZ直径和面积与CCT的相关性最佳。 （注：原文中“< 0.001”处P值未完整给出）
