One-stop shop assessment for atrial septal defect closure using 256-slice coronary CT angiography
One-stop shop assessment for atrial septal defect closure using 256-slice coronary CT angiography
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DOI：
10.1007/s00330-016-4407-2
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发表时间：
2017-02
影响因子：
5.9
通讯作者：
Y. Yamasaki;M. Nagao;S. Kawanami;T. Kamitani;Koji Sagiyama;T. Yamanouchi;I. Sakamoto;Kenichiro Yamamura;H. Yabuuchi;H. Honda
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文献类型：
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作者：
Y. Yamasaki;M. Nagao;S. Kawanami;T. Kamitani;Koji Sagiyama;T. Yamanouchi;I. Sakamoto;Kenichiro Yamamura;H. Yabuuchi;H. Honda
目的探讨256层螺旋CT测量继发性房间隔缺损（ASD）肺动脉/体循环血流比值（Qp/Qs）、缺损大小及边缘大小的可行性和准确性。与参考经食管超声心动图（TEE）和右心导管（RHC）测量结果进行比较。CCTA）、TEE和RHC入组本研究。采用CCTA双心室容积法计算右心室（RV）和左心室（LV）每搏输出量（SV）。Qp/Qs-CT定义为RVSV/LVSV。通过多平面重建CT图像测量缺损及边缘的大小。用Pearson相关系数分析Qp/Qs-CT和Qp/Qs-RHC之间以及CT和TEE测量的缺损直径之间的相关性。结果Qp/Qs-CT与Qp/Qs-RHC呈显著正相关（r = 0.83，p < 0.0001），CT与TEE测量的缺损直径呈显著正相关（r = 0.95，p < 0.0001）。结论256层CCTA可测量继发性ASD患者的Qp/Qs、缺损大小和边缘大小，实现无创、全面的术前评估。要点·CT可准确、可靠地定量左向右分流。使用256层CT可以精确测量缺陷和边缘的大小。·256-切片CT允许对ASD进行非侵入性和全面的预处理评估。
ObjectivesTo investigate the feasibility and accuracy of measurement of the pulmonary to systemic blood flow ratio (Qp/Qs) and defect and rim sizes in secundum atrial septal defects (ASDs) using 256-slice CT, compared to the reference transoesophageal echocardiography (TEE) and right heart catheterization (RHC) measurements.MethodsTwenty-three consecutive adult patients with secundum ASDs who underwent retrospective ECG-gated coronary CT angiography (CCTA), TEE and RHC were enrolled in this study. Right ventricular (RV) and left ventricular (LV) stroke volumes (SV) were calculated by biventricular volumetry of CCTA. Qp/Qs-CT was defined as RVSV/LVSV. The sizes of the defect and rim were measured by multi-planar reconstruction CT images. Correlations between Qp/Qs-CT and Qp/Qs–RHC and between the defect diameter obtained by CT and TEE were analyzed by Pearson’s coefficient analysis. Rim sizes by CT and TEE were compared by pairedt-test.ResultsQp/Qs-CT was significantly correlated with Qp/Qs-RHC (r = 0.83, p < 0.0001), and the defect diameter by CT was significantly correlated with that by TEE (r = 0.95, p < 0.0001). There was no significant difference between CT and TEE in measurements of rim size.Conclusions256-slice CCTA allows measuring Qp/Qs and size of defects and rims in patients with secundum ASDs, accomplishing pretreatment evaluation non-invasively and comprehensively.Key Points• Quantification of left-to-right shunting can be performed reliably and accurately by CT.• The sizes of defects and rims can be measured accurately using 256-slice CT.• 256-slice CT permits pretreatment evaluation of ASD non-invasively and comprehensively.