中国医药
中國醫藥
중국의약
China Medicine
2015年
9期
1282-1286
,共5页
朱茜%陈莎莎%宁忠平%李新明
硃茜%陳莎莎%寧忠平%李新明
주천%진사사%저충평%리신명
双源多层计算机断层扫描血管成像%血管内超声%二尖瓣反流%经皮二尖瓣环缩术%冠状静脉窦
雙源多層計算機斷層掃描血管成像%血管內超聲%二尖瓣反流%經皮二尖瓣環縮術%冠狀靜脈竇
쌍원다층계산궤단층소묘혈관성상%혈관내초성%이첨판반류%경피이첨판배축술%관상정맥두
Dual-source multidetector computed tomography%Intravascular ultrasound%Mitral regurgitation%Percutaneous mitral annulus repair%Coronary vein ostium
目的 采用双源多层计算机断层扫描血管成像(MDCTA)定量评价经冠状静脉窦二尖瓣环缩术的目标置入部位的准确性.方法 入选2013年10月至2014年10月42例拟行心脏再同步化治疗(C RT)的患者,于CRT之前行双源MDCTA检查,测量冠状静脉窦口(CSO)内径、前室间沟静脉近段(PAW)内径和二者之间的距离.在CRT过程中进行血管内超声(IVUS)检查,测量CSO、PAIV内径及二者之间的距离.比较2种检测方法所得结果的相关性及差异.所有患者根据心脏超声所测平均二尖瓣反流(MR)程度分为MR组[继发性二尖瓣反流(SMR)程度≥3级]及对照组(SMR≤2级),比较2组CSO、PAlV内径差异.结果 双源MDCTA测得CSO、PAIV内径和二者之间的距离分别为(11.40 ±0.29)、(4.60±0.11)、(119.40±2.50)mm,IVUS测得为(10.80±0.28)、(5.20±0.13)、(120.10±2.39) mm,2种检查方法测值差异无统计学意义(P＞0.05),呈强直线相关(r=0.967,r=0.954,r=0.986,P＜0.001).与对照组比较,MR组患者双源MDCTA及IVUS测得的CSO、PAIV内径均大于对照组[双源MDCTA:(12.20±0.30) mm比(11.20±0.21) mm、(4.90±0.16) mm比(4.50±0.07) mm,IVUS:(11.70±0.31)mm比(10.60±0.20) mm、(5.40 ±0.17)mm比(5.10±0.09)mm,P＜0.05],CSO与PAIV距离2组间差异无统计学意义(P=0.110、0.112).结论 双源MDCTA可以准确定量测量经冠状静脉窦二尖瓣环缩术目标置入部位,是很好的指导置入器械选择的影像学评价手段.
目的 採用雙源多層計算機斷層掃描血管成像(MDCTA)定量評價經冠狀靜脈竇二尖瓣環縮術的目標置入部位的準確性.方法 入選2013年10月至2014年10月42例擬行心髒再同步化治療(C RT)的患者,于CRT之前行雙源MDCTA檢查,測量冠狀靜脈竇口(CSO)內徑、前室間溝靜脈近段(PAW)內徑和二者之間的距離.在CRT過程中進行血管內超聲(IVUS)檢查,測量CSO、PAIV內徑及二者之間的距離.比較2種檢測方法所得結果的相關性及差異.所有患者根據心髒超聲所測平均二尖瓣反流(MR)程度分為MR組[繼髮性二尖瓣反流(SMR)程度≥3級]及對照組(SMR≤2級),比較2組CSO、PAlV內徑差異.結果 雙源MDCTA測得CSO、PAIV內徑和二者之間的距離分彆為(11.40 ±0.29)、(4.60±0.11)、(119.40±2.50)mm,IVUS測得為(10.80±0.28)、(5.20±0.13)、(120.10±2.39) mm,2種檢查方法測值差異無統計學意義(P＞0.05),呈彊直線相關(r=0.967,r=0.954,r=0.986,P＜0.001).與對照組比較,MR組患者雙源MDCTA及IVUS測得的CSO、PAIV內徑均大于對照組[雙源MDCTA:(12.20±0.30) mm比(11.20±0.21) mm、(4.90±0.16) mm比(4.50±0.07) mm,IVUS:(11.70±0.31)mm比(10.60±0.20) mm、(5.40 ±0.17)mm比(5.10±0.09)mm,P＜0.05],CSO與PAIV距離2組間差異無統計學意義(P=0.110、0.112).結論 雙源MDCTA可以準確定量測量經冠狀靜脈竇二尖瓣環縮術目標置入部位,是很好的指導置入器械選擇的影像學評價手段.
목적 채용쌍원다층계산궤단층소묘혈관성상(MDCTA)정량평개경관상정맥두이첨판배축술적목표치입부위적준학성.방법 입선2013년10월지2014년10월42례의행심장재동보화치료(C RT)적환자,우CRT지전행쌍원MDCTA검사,측량관상정맥두구(CSO)내경、전실간구정맥근단(PAW)내경화이자지간적거리.재CRT과정중진행혈관내초성(IVUS)검사,측량CSO、PAIV내경급이자지간적거리.비교2충검측방법소득결과적상관성급차이.소유환자근거심장초성소측평균이첨판반류(MR)정도분위MR조[계발성이첨판반류(SMR)정도≥3급]급대조조(SMR≤2급),비교2조CSO、PAlV내경차이.결과 쌍원MDCTA측득CSO、PAIV내경화이자지간적거리분별위(11.40 ±0.29)、(4.60±0.11)、(119.40±2.50)mm,IVUS측득위(10.80±0.28)、(5.20±0.13)、(120.10±2.39) mm,2충검사방법측치차이무통계학의의(P＞0.05),정강직선상관(r=0.967,r=0.954,r=0.986,P＜0.001).여대조조비교,MR조환자쌍원MDCTA급IVUS측득적CSO、PAIV내경균대우대조조[쌍원MDCTA:(12.20±0.30) mm비(11.20±0.21) mm、(4.90±0.16) mm비(4.50±0.07) mm,IVUS:(11.70±0.31)mm비(10.60±0.20) mm、(5.40 ±0.17)mm비(5.10±0.09)mm,P＜0.05],CSO여PAIV거리2조간차이무통계학의의(P=0.110、0.112).결론 쌍원MDCTA가이준학정량측량경관상정맥두이첨판배축술목표치입부위,시흔호적지도치입기계선택적영상학평개수단.
Objective To evaluate the accuracy of dual-source multi-detector computed tomography (MDCTA) in evaluating the target location of trans-coronary sinus devices during percutaneous mitral annulus repair.Methods Totally 42 patients planning to receive cardiac resynchronization therapy (CRT) were enrolled.All the patients underwent dual-source MDCTA before CRT and intravenous ultrasound (IVUS) during CRT to measure the diameters of coronary sinus ostium (CSO) and proximal anterior interventricular vein (PAIV),and the distance between CSO and PAIV.The results of dual-source MDCTA and IVUS were analyzed.According to the degree of secondary mitral regurgitation (SMR),the patients were divided into mitral regurgitation (MR) group (SMR≥3 grade) and control group(SMR ≤2 grade); the diameters of CSO and PAIV,and the distance between CSO and PAIV were compared between the two groups.Results The diameters of CSO and PAIV,and the distance between CSO and PAIV measured by dual-source MDCTA and IVUS were not significantly different [(11.40±0.29) mm vs (10.80±0.28) mm,(4.60 ±0.11) mm vs (5.20 ±0.13) mm,(119.40 ± 2.50) mm vs (120.10 ±2.39) mm] (P ＞0.05),and they were linearly correlated (r =0.967,r =0.954,r =0.986,P ＜0.001).For both dual-source MDCTA and IVUS,the diameters of CSO and PAIV in MR group were significantly greater than those in control group [dual-source MDCTA:(12.20 ± 0.30) mm vs (11.20 ± 0.21) mm,(4.90±0.16) mmvs (4.50±0.07) mm,IVUS:(11.70±0.31) mmvs (10.60±0.20) mm,(5.40 ±0.17) mm vs (5.10 ±0.09) mm] (P＜0.05).The distance between CSO and PAIV in MR group was not significantly different compared with that in control group by using both dual-source MDCTA and IVUS (P ＞ 0.05).Conclusion Dual-source MDCTA can quantitatively assess the target location of trans-coronary sinus devices during the percutaneous mitral annulus repair; it may be a good tool for selection of trans-coronary sinus devices for the percutaneous mitral annulus repair.
