多模态对主动脉反的定量评估:一个系统的审查
Jacobo Moreno Garijo1, Andrew Roscoe2, Ashley Farrell3
1From the Department of Anesthesiology and Pain Management, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Cardiology in review
|June 5, 2023
概括
先进的心脏成像方法如3D回声心脏成像 (3DE),CCT和CMR显示出评估大动脉反 (AR) 严重性的前景. CMR提供了最好的可重现性,其次是3DE和CCT,优于传统的2DE方法.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 诊断技术 诊断技术
背景情况:
- 大动脉反 (AR) 严重程度的量化对于患者管理至关重要.
- 传统的二维心声回声 (2DE) 在准确评估AR方面存在局限性.
- 先进的成像模式提供了潜在的改进.
研究的目的:
- 系统地审查3D心声回声 (3DE),心脏计算机断层扫描 (CCT) 和心脏磁共振 (CMR) 测量AR严重性的一致性和可重复性.
- 将这些先进方法的性能与2DE进行比较.
主要方法:
- 对Medline,Embase和Cochrane数据库进行系统的文献搜索 (开始至2022年2月).
- 包括使用3DE,CCT或CMR量化AR严重性的研究.
- 测量协议,观测者内部和观测者间可重复性数据的提取和分析.
- 使用QUADAS-2工具进行质量评估.
主要成果:
- 审查了42篇涉及2176名AR患者的出版物.
- 3DE方法 (VC宽度,VC面积,EROA) 与AR体积的相关性比2DE更好.
- 对于吐量,CCT与2DE显示了中等到良好的相关性.
- 在CMR中,由于心脏内分辨率优越,几何假设较少,观察者内部和观察者间变异性最低.
- 3DE和CCT比2DE有所改善,CCT是患有心声窗口差的患者的选择.
结论:
- 与2DE相比,先进的成像技术 (3DE,CCT,CMR) 为AR严重程度评估提供了更好的准确性和可重复性.
- CMR提供了最高的可重现性,使其适用于临床试验和复杂的病例.
- 3DE和CCT是有价值的替代品,特别是当2DE不足或CMR不可行时.
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