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经导管主动脉瓣置换术前基于CT的主动脉根部测量的相关思考:与3mensio测量的一致性及对短期预后的影响

[Anythink for CT-based aorta root measurements before transcatheter aortic valve replacement: measurement consistency with 3mensio and impact on short-term prognosis].

作者信息

Liu C, Sun Z, Wang J, Wang M, Xin R, Ding Y, Wang X, Mu Y, Chen T, Jiang B, Wang L, Zhang M, Shan D, Chen Y

机构信息

Senior Department of Cardiology, Sixth Medical Center of PLA General Hospital, Beijing 100853, China.

School of Medicine, Nankai University, Tianjin 300071, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2022 Nov 20;42(11):1646-1654. doi: 10.12122/j.issn.1673-4254.2022.11.08.

Abstract

OBJECTIVE

To evaluate the consistency and reproducibility of aortic root measurements by Anythink, a semi-automated preoperative CT analysis software, with those of 3mensio.

METHODS

Sixty-seven patients undergoing transcatheter aortic valve replacement (TAVR) in the First Medical Center of Chinese PLA General Hospital from December, 2016 to February, 2022 were retrospectively enrolled in this study. A cardiology resident who completed his professional training used both the software Anythink and 3mensio (as the gold standard) to reconstruct the aortic root model and analyze the parameters of the aortic annulus and the surrounding structures. The correlation and consistency of the measurement results of two software were analyzed. Two independent residents also used Anythink software to repeat the measurements for the same patient for assessment of the reproducibility of Anythink measurements. The valve models were selected based on the measurements by Anythink and 3mensio, and similarities and differences of the two software in clinical valve selection were assessed.

RESULTS

The measurements of the distances from the anulus plane to the left and right coronary ostium, average diameter of the anulus, anulus area, anulus perimeter, and the angle between the annulus and horizontal plane did not differ significantly between the two software ( > 0.05), and their measurements showed positive correlations (= 0.884-0.981, < 0.01). The intra-group and inter-group correlation coefficients of the anulus parameters measured by Anythink ranged from 0.894 to 0.992 and from 0.651 to 0.954, respectively. The Kappa-test values of valve models selected by Anythink and 3mensio based on the average diameter, area diameter and perimeter diameter were 0.886, 0.796 and 0.775, respectively. The intra-group Kappa values for the valve models selected based on Anythink measurements were 0.819, 0.841, and 0.795, and the inter-group Kappa values were 0.812, 0.812, and 0.768, respectively. Compared with the measurements by 3mensio, the recommended area diameter measured by Anythink was slightly greater in patients with postoperative paravalvular leakage, but slightly smaller in patients with postoperative new-onset conduction block.

CONCLUSION

Anythink has excellent measurement consistency and high reproducibility for aortic root measurements, and trained cardiologists can use Anythink to obtain accurate aortic root parameters before TAVR.

摘要

目的

评估半自动术前CT分析软件Anythink与3mensio对主动脉根部测量的一致性和可重复性。

方法

回顾性纳入2016年12月至2022年2月在中国人民解放军总医院第一医学中心接受经导管主动脉瓣置换术(TAVR)的67例患者。一名完成专业培训的心脏科住院医师使用Anythink软件和3mensio(作为金标准)重建主动脉根部模型并分析主动脉瓣环及周围结构的参数。分析两种软件测量结果的相关性和一致性。两名独立的住院医师也使用Anythink软件对同一患者重复测量,以评估Anythink测量的可重复性。根据Anythink和3mensio的测量结果选择瓣膜模型,评估两种软件在临床瓣膜选择上的异同。

结果

两种软件在瓣环平面至左右冠状动脉开口的距离、瓣环平均直径、瓣环面积、瓣环周长以及瓣环与水平面夹角的测量上差异无统计学意义(>0.05),且测量结果呈正相关(=0.884 - 0.981,<0.01)。Anythink测量的瓣环参数组内和组间相关系数分别为0.894至0.992和0.651至0.954。基于平均直径、面积直径和周长直径,Anythink和3mensio选择的瓣膜模型的Kappa检验值分别为0.886、0.796和0.775。基于Anythink测量结果选择的瓣膜模型组内Kappa值分别为0.819、0.841和0.795,组间Kappa值分别为0.812、0.812和0.768。与3mensio的测量结果相比,Anythink测量的推荐面积直径在术后瓣周漏患者中略大,但在术后新发传导阻滞患者中略小。

结论

Anythink在主动脉根部测量方面具有出色的测量一致性和高可重复性,经过培训的心脏科医生可在TAVR术前使用Anythink获得准确的主动脉根部参数。

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