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三维超声心动图与计算机断层扫描评估二尖瓣环尺寸:对经导管介入治疗的意义

Mitral Valve Annulus Dimensions Assessment with Three-Dimensional Echocardiography Versus Computed Tomography: Implications for Transcatheter Interventions.

作者信息

Hirasawa Kensuke, Vo N Mai, Gegenava Tea, Pio Stephan Milhorini, van Wijngaarden Suzanne E, Ajmone Marsan Nina, Bax Jeroen J, Delgado Victoria

机构信息

Department of Cardiology, Heart Lung Centre, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.

出版信息

J Clin Med. 2021 Feb 8;10(4):649. doi: 10.3390/jcm10040649.

DOI:10.3390/jcm10040649
PMID:33567645
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7915882/
Abstract

The aim of this study is to evaluate the agreement between three-dimensional (3D) transesophageal echocardiography (TEE) and multidetector computed tomography (MDCT) for assessing mitral annular (MA) dimensions. A total of 105 patients (79 ± 9 years old, 52% male) who underwent clinically indicated 3D TEE and MDCT feasible for MA geometrical assessment were included. Using dedicated semi-automated postprocessing software, MA geometry, including mitral annular area (MAA), perimeter, septal-lateral (SL) diameter, and inter-trigonal (TT) diameter, was evaluated using 3D TEE and MDCT. Compared to 3D TEE, MAA, perimeter, and SL distance measured on MDCT data were larger (9.9 ± 3.0 vs. 9.3 ± 3.1 cm for MAA; 115 ± 18 vs. 108 ± 18 mm for perimeter; and 35 ± 5 vs. 32 ± 5 cm for SL distance, all < 0.001). By contrast, the TT distance was comparable between MDCT and 3D TEE (26 ± 4 vs. 26 ± 4 cm, = 0.258). The correlations of all the MA dimensions were good to excellent between the two modalities (R = 0.911 for MAA, 0.890 for perimeter, 0.739 for TT distance, and 0.857 for SL distance, respectively, all < 0.001). This study showed good agreement between 3D TEE- and MDCT-derived MA measurements although MDCT systematically provided larger MAA, perimeter, and SL distance compared with 3D TEE.

摘要

本研究旨在评估三维(3D)经食管超声心动图(TEE)与多排螺旋计算机断层扫描(MDCT)在评估二尖瓣环(MA)尺寸方面的一致性。纳入了105例患者(年龄79±9岁,男性占52%),这些患者接受了临床指征的3D TEE检查且MDCT检查可行,可用于MA几何形状评估。使用专用的半自动后处理软件,通过3D TEE和MDCT评估MA几何形状,包括二尖瓣环面积(MAA)、周长、间隔-侧壁(SL)直径和三角间(TT)直径。与3D TEE相比,MDCT数据测量的MAA、周长和SL距离更大(MAA:9.9±3.0 vs. 9.3±3.1 cm;周长:115±18 vs. 108±18 mm;SL距离:35±5 vs. 32±5 cm,均P<0.001)。相比之下,MDCT和3D TEE之间的TT距离相当(26±4 vs. 26±4 cm,P = 0.258)。两种检查方法之间所有MA尺寸的相关性均良好至极佳(MAA的R = 0.911,周长的R = 0.890,TT距离的R = 0.739,SL距离的R = 0.857,均P<0.001)。本研究表明3D TEE和MDCT得出的MA测量值之间具有良好的一致性,尽管与3D TEE相比,MDCT系统性地提供了更大的MAA、周长和SL距离。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e84/7915882/822cf1ec5dcc/jcm-10-00649-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e84/7915882/ac808595c9c6/jcm-10-00649-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e84/7915882/822cf1ec5dcc/jcm-10-00649-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e84/7915882/ac808595c9c6/jcm-10-00649-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e84/7915882/822cf1ec5dcc/jcm-10-00649-g002.jpg

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本文引用的文献

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Assessment of D-Shaped Annulus of Mitral Valve in Patients with Severe MR Using Semi-Automated 4-Dimensional Analysis: Implications for Transcatheter Interventions.使用半自动四维分析评估重度二尖瓣反流患者的D形二尖瓣环:对经导管干预的意义
J Cardiovasc Dev Dis. 2020 Nov 1;7(4):48. doi: 10.3390/jcdd7040048.
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Transcatheter Interventions for Mitral Regurgitation: Multimodality Imaging for Patient Selection and Procedural Guidance.
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Imaging for Mitral Interventions: Methods and Efficacy.二尖瓣介入治疗的影像学评估:方法与疗效。
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Use of Cardiac Computerized Tomography to Predict Neo-Left Ventricular Outflow Tract Obstruction Before Transcatheter Mitral Valve Replacement.使用心脏计算机断层扫描预测经导管二尖瓣置换术前新的左心室流出道梗阻。
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