心脏磁共振成像用于皮肤穿左心房尾关闭的手术前规划
Dagmar Bertsche1, Patrick Metze1, Erfei Luo1
1Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
Frontiers in cardiovascular medicine
|July 10, 2023
概括
无对比心磁共振成像 (CMR) 准确地测量了左心房附属体 (LAA) 的尺寸,用于在LAA关闭程序中选择设备. 这种成像技术有助于最佳的设备定位,并减少了解剖评估的挑战.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 干预程序 干预程序
背景情况:
- 穿皮左心房附属体 (LAA) 关闭对于心房患者中风预防至关重要.
- 对LAA进行准确的解剖评估对于在LAA关闭期间最佳的设备选择和定位至关重要.
- 目前像TEE和XR这样的成像模式都有局限性,包括设备低估,而CTA增加了辐射和对比负担.
研究的目的:
- 研究非对比增强心磁共振成像 (CMR) 对于LAA关闭 (LAAc) 程序前规划的实用性.
- 评估CMR在量化LAA尺寸和确定LAAc最佳C臂角度方面的准确性.
主要方法:
- 13名患者接受了LAAc前的CMR.
- 使用3DCMR数据量化了LAA尺寸 (最大直径,外围直径,面积直径).
- 从CMR确定了最佳的C臂角度,并与周围手术测量进行了比较.
主要成果:
- 从CMR获得的基于周边和面积的LAA直径与周边过程X射线测量结果有很好的一致性.
- 与XR和TEE相比,CMR测量的最大直径显著高估了LAA尺寸 (p <0.05).
- 通过CMR确定的C臂角度与循环LAA解剖的程序角度保持一致.
结论:
- 非对比增强的CMR显示为程序前LAAc规划的前景.
- 基于面积和周长的CMR衍生的LAA测量与设备选择参数相对应.
- 在LAA关闭期间,CMR促进了精确的C臂角度,以实现最佳的设备放置.
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