左心室和肺静脉的三维建模,使用精确的心内心声谱方法进行三维建模
Xue Xia1, Huan Sun1, Xiuming Zhou2
1Cardiology Department, China-Japan Union Hospital of Jilin University.
Journal of visualized experiments : JoVE
|July 17, 2023
概括
心内回声学 (ICE) 提供了左心房和肺静脉的精确3D建模,在肺静脉隔离程序的准确性上超过了快速解剖绘图 (FAM).
科学领域:
- 心血管成像 - 心血管成像
- 电子生理学 电子生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 心脏内心回声学 (ICE) 在肺静脉隔离 (PVI) 期间用于左心房 (LA) 和肺静脉 (PV) 解剖学的评估.
- 目前使用ICE创建3D LA模型的方法需要与其他技术相比验证准确性.
研究的目的:
- 建议和评估一个使用ICE精确的3D左心房和肺静脉建模的协议.
- 为了比较基于ICE的3D建模与快速解剖绘图 (FAM) 导管改造的准确性.
主要方法:
- 一个结合ICE和FAM导管改造的协议被开发用于3DLA和PV解剖建模.
- 包括50名在PVI手术期间接受ICE改造的患者和45名在PVI手术期间接受FAM改造的患者.
- 通过观察者得分和对肺静脉部区域与左心房计算机断层扫描血管造影 (CTA) 的比较,使用布兰德-阿尔特曼分析来评估准确性.
主要成果:
- 与FAM (3.02 ± 0.72) 相比,基于ICE的3D建模实现了显著更高的观察者得分 (3.40 ± 0.81).
- 这两种方法都与LA CTA相关,但ICE模型显示出更窄的95%置信区间偏差.
- 布兰德-阿尔特曼分析表明,ICE获得的模型在估计PV antrum面积方面具有更高的精度.
结论:
- 精确的基于ICE的3D建模在估计心脏结构,特别是左前庭和肺静脉方面表现出高度准确性.
- ICE是心脏手术中解剖估计的一个有前途的工具,有可能改进跨septal方法.
- 这项研究验证了ICE作为一种可靠的方法,用于在PVI期间创建准确的3D解剖模型.
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