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经导管主动脉瓣置换术(TAVI)前影像学检查:意大利 CT 协议优化(CT-PRO)组的一项调查。

Pre-TAVI imaging: an Italian survey by the CT PRotocol optimization (CT-PRO) group.

机构信息

Unit of Diagnostic and Interventional Imaging, Department BIOMORF, University of Messina, Via Consolare Valeria 1, Messina, 98100, Italy.

Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.

出版信息

Int J Cardiovasc Imaging. 2024 Apr;40(4):831-839. doi: 10.1007/s10554-024-03052-8. Epub 2024 Jan 24.

Abstract

PURPOSE

The purpose of this survey was to evaluate the current state-of-art of pre-TAVI imaging in a large radiological professional community.

METHODS

Between December 2022 and January 2023 all members of the Italian Society of Medical and Interventional Radiology (SIRM) were invited by the CT PRotocol Optimization group (CT-PRO group) to complete an online 24-item questionnaire about pre-TAVI imaging.

RESULTS

557 SIRM members participated in the survey. The greatest part of respondents were consultant radiologists employed in public hospitals and 84% claimed to routinely perform pre-TAVI imaging at their institutions. The most widespread acquisition protocol consisted of an ECG-gated CT angiography (CTA) scan of the aortic root and heart followed by a non-ECG-synchronized CTA of the thorax, abdomen, and pelvis. Contrast agent administration was generally tailored on the patient's body weight with a preference for using high concentration contrast media. The reports were commonly written by radiologists with expertise in cardiovascular imaging, and included all the measurements suggested by current guidelines for adequate pre-procedural planning. About 60% of the subjects affirmed that the Heart Team is present at their institutions, however only 7% of the respondents regularly attended the multidisciplinary meetings.

CONCLUSIONS

This survey defines the current pre-TAVI imaging practice in a large radiological professional community. Interestingly, despite the majority of radiologists follow the current guidelines regarding acquisition and reporting of pre-TAVI imaging studies, there is still a noteworthy absence from multidisciplinary meetings and from the Heart Team.

摘要

目的

本调查旨在评估大型放射专业社区中经导管主动脉瓣置换术(TAVI)前影像学的现状。

方法

2022 年 12 月至 2023 年 1 月,意大利医学和介入放射学会(SIRM)的所有成员均受邀参加 CT 协议优化组(CT-PRO 组)的在线 24 项问卷调查,内容涉及 TAVI 前影像学。

结果

共有 557 名 SIRM 成员参与了这项调查。大多数受访者为公立医院的顾问放射科医生,84%的人声称在其机构常规进行 TAVI 前影像学检查。最广泛使用的采集方案包括主动脉根部和心脏的心电图门控 CT 血管造影(CTA)扫描,然后是非心电图同步的胸部、腹部和骨盆 CTA。造影剂的给药通常根据患者的体重进行调整,倾向于使用高浓度造影剂。报告通常由具有心血管成像专业知识的放射科医生撰写,包括当前指南建议的所有用于充分术前规划的测量值。约 60%的受访者表示他们所在的机构有心脏团队,但只有 7%的受访者定期参加多学科会议。

结论

这项调查定义了大型放射专业社区中目前的 TAVI 前影像学实践。有趣的是,尽管大多数放射科医生在获取和报告 TAVI 前影像学研究方面遵循了现行指南,但他们仍明显缺席多学科会议和心脏团队。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb62/11052815/11c190eb29cf/10554_2024_3052_Fig2_HTML.jpg

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