Echocardiographic Imaging Center, No.167 North Lishi Road, Xicheng District, Beijing, China.
Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Int J Cardiol. 2023 Jul 15;383:151-158. doi: 10.1016/j.ijcard.2023.03.027. Epub 2023 Mar 31.
Tricuspid valve (TV) sizing is crucial for surgical or interventional procedures planning. Imaging TV is frequently challenging and often requires multimodal imaging techniques. Computed tomography (CT) is the gold standard for sizing. The authors compared measurements of the tricuspid annulus (TA) acquired using echocardiography and CT.
Thirty-six patients with severe symptomatic tricuspid regurgitation were included in this retrospective analysis. During mid-diastole, the maximal two-dimensional (2D) TA diameter was directly measured in multiple views using transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). Three-dimensional (3D) TA size was assessed using cross-sectional long-axis and short-axis diameters, areas, and perimeters measured in the projected plane. The TA diameter was quantified by the perimeter measured on the CT images (CT imaging_indirect) and compared with echocardiography measurements. Tenting height and tenting area were also measured using TTE at mid systole.
The long-axis dimensions measured using 3DTEE (3DTEE_direct) best correlated with the TA diameter (CT imaging_indirect) (R = 0.851, P = 0.0001) and the least discrepancies (difference 1.2 ± 2.4 mm, P = 0.012). The TA diameters quantified by the perimeters measured using 3DTEE (3DTEE_indirect) were smaller than the CT values (difference 2.5 ± 2.5 mm, P = 0.0001). The maximal dimensions directly measured by 2DTEE (2DTEE_direct) were modestly correlated with the CT values. Overall, the maximal dimensions by TTE_direct were less reliable than those by CT. TA eccentricity index correlated with the maximal tenting height and area.
The patients with severe tricuspid regurgitation had a dilated and circular annulus. The long-axis TA dimensions (3DTEE_direct) were similar to the diameters (CT imaging_indirect).
三尖瓣（TV）大小对于手术或介入程序的规划至关重要。成像 TV 常常具有挑战性，并且通常需要多种模态成像技术。计算机断层扫描（CT）是 TV 大小的金标准。作者比较了使用超声心动图和 CT 获得的三尖瓣环（TA）测量值。
本回顾性分析纳入 36 例严重症状性三尖瓣反流患者。在舒张中期，使用经胸超声心动图（TTE）和经食管超声心动图（TEE）在多个视图中直接测量最大二维（2D）TA 直径。使用在投影平面上测量的横断面长轴和短轴直径、面积和周长评估 3D TA 大小。TA 直径通过 CT 图像上测量的周长（CT imaging_indirect）进行量化，并与超声心动图测量值进行比较。在收缩中期还使用 TTE 测量了帐篷高度和帐篷面积。
使用 3DTEE（3DTEE_direct）测量的长轴尺寸与 TA 直径（CT imaging_indirect）（R=0.851，P=0.0001）相关性最佳，差异最小（1.2±2.4mm，P=0.012）。使用 3DTEE 测量的周长量化的 TA 直径（3DTEE_indirect）小于 CT 值（差异 2.5±2.5mm，P=0.0001）。2DTEE（2DTEE_direct）直接测量的最大尺寸与 CT 值中度相关。总体而言，TTE_direct 的最大尺寸不如 CT 可靠。TA 偏心指数与最大帐篷高度和面积相关。
严重三尖瓣反流患者的三尖瓣环扩张且呈圆形。TA 的长轴尺寸（3DTEE_direct）与直径（CT imaging_indirect）相似。
