Magnetic Resonance Imaging Versus Computed Tomography for Characterization of Pulmonary Vein Morphology Before Radiofrequency Catheter Ablation of Atrial Fibrillation
Magnetic Resonance Imaging Versus Computed Tomography for Characterization of Pulmonary Vein Morphology Before Radiofrequency Catheter Ablation of Atrial Fibrillation
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DOI：
10.1016/j.amjcard.2009.07.029
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发表时间：
2009-12-01
影响因子：
2.8
通讯作者：
Fleck, Eckart
中科院分区：
文献类型：
--
作者：
Hamdan, Ashraf;Charalampos, Kriatselis;Fleck, Eckart
准确评估肺静脉（PV）解剖对心房颤动（AF）射频导管消融（RFCA）的规划具有重要意义。本研究的目的是执行进行比较,磁共振成像(MRI)和多层螺旋计算机断层扫描(CT) PV形态学评估之前RFCA房颤。对比增强磁共振成像(1.5 - t系统)和多层螺旋CT在双源(系统)进行连续评估44的PV患者(31人,平均年龄56 + / - 10年)承认RFCA drug-refractory AF。PV解剖学数据,开口病变分支模式,比较MRI与多层螺旋CT的口腔尺寸。21例（48%）患者采用两种成像方式观察到不同的PV解剖结构。通过MRI和多层螺旋CT的评估，PV口分支的发生率在右侧较高，在下静脉比上静脉更常见。两种成像方式在评估变异PV解剖（kappa = 0.87, 95%可信区间0.77 ~ 0.97）和口部分支模式（kappa = 0.84, 95%可信区间0.75 ~ 0.93）之间的一致性几乎是完美的。评估PV口横截面积以及最大和最小口直径导致了强烈的一致性和相关性(r(2) = 0.75至0.99,p
The accurate assessment of pulmonary vein (PV) anatomy is important in planning radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). The aim of the present study was to perform a head-to-head comparison of magnetic resonance imaging (MRI) and multislice computed tomography (CT) for the evaluation of PV morphology before RFCA of AF. Contrast-enhanced MRI (on a 1.5-T system) and multislice CT (on a dual-source system) were performed for the evaluation of the PVs in 44 consecutive patients (31 men, mean age 56 +/- 10 years) admitted for RFCA of drug-refractory AF. Data on PV anatomy, ostial branching pattern, and ostial dimensions were compared between MRI and multislice CT. Variant PV anatomy was observed in 21 patients (48%) with the 2 imaging approaches. The incidence of PV ostial branching, as assessed with MRI and multislice CT, was higher on the right and more common in the inferior than superior vein. Agreement between the 2 imaging modalities for the evaluation of variant PV anatomy (kappa = 0.87, 95% confidence interval 0.77 to 0.97) and ostial branching pattern (kappa = 0.84, 95% confidence interval 0.75 to 0.93) was nearly perfect. Assessment of PV ostial cross-sectional area as well as maximal and minimal ostial diameters resulted in strong agreement and correlation (r(2) = 0.75 to 0.99, p