心内三维图像作为先天性心脏病的手术决策工具
Sho Isobe1, Yuzo Katayama2, Tsukasa Ozawa1
1Division of Cardiovascular Surgery, Department of Surgery, Toho University Omori Medical Center, 6-11 Omori-Nishi Ota-Ku, Tokyo, 143-8541, Japan.
Pediatric cardiology
|November 28, 2023
概括
手术前的心脏内3D图像 (IC图像) 改善了手术决策,用于与PS相关的先天性心脏缺陷,如VSD和DORV/TGA. 与传统方法相比,IC图像提供了更高的诊断一致性和解剖细节.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 手术规划 手术规划
背景情况:
- 像心室隔膜缺陷 (VSD) 这样的先天性心脏病 (CHD) 和复杂的疾病,如双出口右心室 (DORV) 或大动脉转移 (TGA) 与肺狭窄 (PS) 需要精确的手术规划.
- 准确的解剖学评估对于儿童心脏外科手术的成功手术结果至关重要.
研究的目的:
- 评估手术前心内3D图像 (IC图像) 的解剖复制性,这些图像是从计算机断层扫描 (CT) 中生成的.
- 评估IC图像作为VSD和PS患者的DORV/TGA手术决策工具的实用性.
主要方法:
- 从2012-2022年对心脏手术中患有VSD或DORV/TGA的患者进行CT扫描的回顾性分析.
- 使用SYNAPSE VINCENT®软件创建和分析心内3D图像.
- 对IC图像诊断一致性和测量与手术内发现和胸前心电回声 (TTE) 的比较.
主要成果:
- 对于VSD患者,IC图像实现了100%的诊断一致性 (Soto分类),而TTE则达到64% (P=0.04).
- 图像显示,IC图像与缺陷大小 (r=0.837) 的相关性高于TTE (r=0.567).
- 对于PS患者的DORV/TGA,IC图像显示了100%的诊断一致性 (Lev分类),而TTE的77% (P=0.47).
- 从IC图像中获得的二次室间孔 (SVF) /左室外流通道 (LVOT) 的比率区分了双室内修复 (0.71) 和单室内修复 (1.79) 组 (P=0.006).
结论:
- 手术前的IC图像是简单的VSD和复杂的CHD,如DORV/TGA与PS等手术决策的宝贵工具.
- 从IC图像中得出的SVF/LVOT比率可以帮助预测和预防左心室外流通道 (LVOT) 手术后的阻塞.
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