3D Fusion of LV Venous Anatomy on Fluoroscopy Venograms With Epicardial Surface on SPECT Myocardial Perfusion Images for Guiding CRT LV Lead Placement
3D Fusion of LV Venous Anatomy on Fluoroscopy Venograms With Epicardial Surface on SPECT Myocardial Perfusion Images for Guiding CRT LV Lead Placement
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DOI：
10.1016/j.jcmg.2014.09.002
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发表时间：
2014-12-01
影响因子：
14
通讯作者：
Chen, Ji
中科院分区：
文献类型：
--
作者：
Zhou, Weihua;Hou, Xiaofeng;Chen, Ji
本研究的目的是开发一种三维（3D）融合工具包，将荧光透视静脉造影片上的左心室（LV）静脉解剖结构与单光子发射计算机断层扫描（SPECT）心肌灌注成像（MPI）上的LV心外膜表面结合起来，以指导心脏起搏治疗（CRT）LV电极导线放置。对于LV铅放置到可行的区域与后期激活，重要的是要可视化LV静脉解剖结构和myocardial.METHODS主要LV静脉手动识别荧光透视静脉造影和自动重建成3D解剖结构。从SPECT MPI中提取3D LV心外膜表面。开发了SPECT-静脉融合，包括几何对齐、基于地标的配准和血管表面叠加，以融合3D静脉解剖结构与心外膜表面。使用计算机断层扫描（CT）静脉造影评价该工具的准确性。在CT图像上手动识别LV心外膜表面和静脉，并由独立操作员与SPECT图像配准。使用SPECT短轴切片上的绝对距离和17段model.Results10例CRT患者入选。短轴心外膜表面上相应的荧光透视和CT静脉之间的距离为4.6 +/- 3.6 mm（范围0 - 16.9 mm）。在17节段模型中存在相应的荧光透视和CT静脉，kappa值为0.87（95%置信区间：0.82 - 0.93）。该工具包被用来指导LV铅放置在导管实验室，并显示临床可行性和效益patient.CONCLUSIONS的工具包已开发的双视图透视静脉图重建3D LV静脉解剖结构，并融合它与LV心外膜表面SPECT MPI。用17段模型指导左心室电极导线置入在技术上是准确的，在导管室临床应用是可行的。(C)2014年由美国心脏病学会基金会。
OBJECTIVES The aim of this study was to develop a 3-dimensional (3D) fusion tool kit to integrate Left ventricular (LV) venous anatomy on fluoroscopy venograms with LV epicardial surface on single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) for guiding cardiac resynchronization therapy (CRT) LV lead placement.BACKGROUND LV lead position is important for CRT response. For LV Lead placement into viable regions with Late activation, it is important to visualize both LV venous anatomy and myocardium.METHODS Major LV veins were manually identified on fluoroscopic venograms and automatically reconstructed into a 3D anatomy. 3D LV epicardial surface was extracted from SPECT MPI. SPECT-vein fusion that consisted of geometric alignment, Landmark-based registration, and vessel-surface overlay was developed to fuse the 3D venous anatomy with the epicardial surface. The accuracy of this tool was evaluated using computed tomography (CT) venograms. LV epicardiaL surfaces and veins were manually identified on the CT images and registered with the SPECT image by an independent operator. The locations of the fluoroscopic and CT veins on the SPECT epicardial surfaces were compared using absolute distances on SPECT short-axis slice and the 17-segment model.RESULTS Ten CRT patients were enrolled. The distance between the corresponding fluoroscopic and CT veins on the short-axis epicardial surfaces was 4.6 +/- 3.6 mm (range 0 to 16.9 mm). The presence of the corresponding fluoroscopic and CT veins in the 17-segment model agreed well with a kappa value of 0.87 (95% confidence interval: 0.82 to 0.93). The tool kit was used to guide LV lead placement in a catheter laboratory and showed clinical feasibility and benefit to the patient.CONCLUSIONS A tool kit has been developed to reconstruct 3D LV venous anatomy from dual-view fluoroscopic venograms and to fuse it with LV epicardial surface on SPECT MPI. It is technically accurate for guiding LV lead placement by the 17-segment model and is feasible for clinical use in the catheterization Laboratory. (C) 2014 by the American College of Cardiology Foundation.