| 孟庆国,尹立雪,曾杰,王胰.三维经食管超声心动图与其他影像技术指导左心耳封堵术的对比[J].中国医学影像技术,2017,33(3):365~369 |
| 三维经食管超声心动图与其他影像技术指导左心耳封堵术的对比 |
| Comparation of three-dimensional transesophageal echocardiography and other imaging techniques in conducting percutaneous left atrial appendage occlusion |
| 投稿时间：2016-09-26 修订日期：2017-02-14 |
| DOI：10.13929/j.1003-3289.201609119 |
| 中文关键词: 左心耳 心房颤动 超声心动描记术,经食管 |
| 英文关键词:Left atrial appendage Atrial fibrillation Echocardiography, transesophageal |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨三维经食管超声心动图（3D-TEE）和2D-TEE、CTA和术中X线造影在左心耳（LAA）形态、大小评估及指导封堵器型号选择方面的价值。方法 对43例拟行LAA封堵术的心房颤动患者行TEE，清晰显示LAA并于0°、45°、90°和135°分别测量其开口最大径和最大深度值；于LAA显示最清晰切面启动3D-ROOM模式测量开口最大径、最小径，并将其与2D-TEE、CTA和X线造影的检查结果进行对比。结果 3D-TEE测量LAA开口最大径与2D-TEE、术中X线造影测值差异无统计学意义（P均>0.05），CTA测量LAA开口最大径明显大于3D-TEE、2D-TEE和X线造影测值（P<0.01）；2D-TEE于90°和135°测量LAA最大深度值与CTA测值差异有统计学意义（P均<0.05），与术中X线造影比较，仅在135°时差异有统计学意义（P<0.01）。3D-TEE测量LAA开口最大径与2D-TEE各角度、CTA和X线造影测值呈明显正相关（r=0.70~0.77、0.57、0.58，P均<0.01）；2D-TEE各角度测量LAA开口最大径与CTA、X线造影测值均存在相关性（r=0.57~0.71，0.45~0.51；P均<0.01）；3D-TEE、2D-TEE、CTA及X线造影LAA开口最大径与封堵器大小均呈明显正相关且（r=0.93、0.70~0.77、0.57、0.47，P均<0.01）。结论 3D-TEE与2D-TEE、CTA和X线造影相比，3D-TEE对于封堵器大小的选择更具指导性。 |
| 英文摘要: |
| Objective To investigate the value of 3D-TEE, 2D-TEE, CTA and X-ray contrast in assessing left atrial appendage (LAA) shape, size and guidance for the choice of occlusion. Methods Forty-three cases of left atrial fibrillation who were referred for LAA closure were performed TEE to measure the opening maximum diameter, and maximum depth of 2D-TEE at 0°, 45°, 90° and 135°. When LAA showed most clearly, the opening maximum and minimum diameter of LAA were measured by using 3D-ROOM mode, and the results were compared with those measured by CTA and X-ray contrast. Results There was no significant difference for opening maximum diameter of LAA measured by 3D-TEE, 2D-TEE and X-ray contrast (all P>0.05), but that of CTA statistically larger than 3D-TEE, 2D-TEE, X-ray contrast (all P<0.01). There were significant difference between 2D-TEE at 90°, 135° and CTA, 2D-TEE at 135° and X-ray contrast in assessing maximum depth of LAA (all P<0.05). Opening maximum diameter of LAA measured by 3D-TEE was significantly correlated with each angle of 2D-TEE, CTA, and X-ray contrast (r=0.70-0.77, 0.57, 0.58, all P<0.01), and the opening maximum diameter measured by 2D-TEE also correlated with CTA and X-ray contrast (r=0.57-0.71, 0.45-0.51, all P<0.01). Also the opening maximum diameter measured by 3D-TEE, 2D-TEE, CTA and x-ray contrast were correlated with occluder size (r=0.93, 0.70-0.77, 0.57, 0.47, all P<0.01). Conclusion Compared with 2D-TEE, CTA and X-ray contrast, 3D-TEE is more instructive for occluder selection. |
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