Park Soojung, Cho Yongwon, Oh Yu-Whan, Ko Minseok, Lim Do-Sun, Yu Cheol Woong, Park Seong-Mi, Kim Mi-Na, Hwang Sung Ho
Department of Radiology, Korea University Anam Hospital, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea.
Korea University College of Medicine, 73, Goryeodae-ro, Seoungbuk-gu, Seoul, 02841, Republic of Korea.
Eur Radiol. 2023 Mar;33(3):1963-1972. doi: 10.1007/s00330-022-09133-3. Epub 2022 Sep 16.
To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS).
A retrospective study was performed on patients who underwent transcatheter aortic valve replacement (TAVR) for symptomatic AVS and underwent both pre and postprocedural electrocardiogram gated CT scans using a spectral CT system. Preprocedural CT was used to evaluate the volume and iodine concentration (IC) in the AVC. Postprocedural CT data were used to calculate the volume reduction percentage (VRP) of AVC. Multiple linear regression analysis was used to identify the independent variables related to the VRP in AVCs.
A total of 94 AVCs were selected from 22 patients. The mean volume and IC of the AVCs before TAVR were 0.37 mL ± 0.15 mL and 7 mg/mL ± 10.5 mg/mL, respectively. After TAVR, a median VRP of all 94 AVCs was 18.5%. Multiple linear regression analysis showed that the IC was independently associated with the VRP (coefficient = 1.64, p < 0.001). When an optimal IC cutoff point was set at 4 mg/mL in the assessment of a fragile AVC which showed the VRP was > 18.5%, the sensitivity was 63%; specificity, 91%; positive predictive value, 88%; and negative predictive value, 71%.
When using spectral CT to prepare the TAVR, measuring the IC of the AVC may be useful to assess the probability of AVC deformity after TAVR.
• A dual-layer detector-based spectral CT enables quantifying iodine of contrast media in the aortic valve calcification (AVC) on contrast-enhanced CT images. • The AVC including iodine of contrast media on contrast-enhanced CT image may have loose compositions, associated with the deformity of AVC after TAVR. • Measuring the iodine concentration in AVC may have the potential to assess the probability of AVC deformity, which may be associated with the outcome and complications after TAVR.2.
探讨光谱计算机断层扫描（CT）测量的碘浓度与主动脉瓣狭窄（AVS）患者主动脉瓣钙化（AVC）强度之间的关系。
对因症状性AVS接受经导管主动脉瓣置换术（TAVR）且术前和术后均使用光谱CT系统进行心电图门控CT扫描的患者进行回顾性研究。术前CT用于评估AVC的体积和碘浓度（IC）。术后CT数据用于计算AVC的体积减少百分比（VRP）。采用多元线性回归分析确定与AVC中VRP相关的独立变量。
从22例患者中选取94个AVC。TAVR术前AVC的平均体积和IC分别为0.37 mL±0.15 mL和7 mg/mL±10.5 mg/mL。TAVR术后，所有94个AVC的VRP中位数为18.5%。多元线性回归分析显示，IC与VRP独立相关（系数 = 1.64，p < 0.001）。在评估VRP > 18.5%的易碎AVC时，将最佳IC截断点设定为4 mg/mL，敏感性为63%；特异性为91%；阳性预测值为88%；阴性预测值为71%。
在使用光谱CT进行TAVR术前评估时，测量AVC的IC可能有助于评估TAVR术后AVC变形的可能性。
•基于双层探测器的光谱CT能够在对比增强CT图像上定量主动脉瓣钙化（AVC）中造影剂的碘含量。•对比增强CT图像上包含造影剂碘的AVC可能结构疏松，与TAVR术后AVC变形有关。•测量AVC中的碘浓度可能有潜力评估AVC变形的可能性，这可能与TAVR术后的结果和并发症相关。
