摘要
目的：探讨心腔内超声心动图（ICE）、经胸超声心动图（TTE）及多层螺旋计算机断层摄影术（MSCT）测量中华小型猪主动脉瓣环直径的差异,为经导管主动脉瓣膜植入术选择最佳的人工瓣膜型号的影像学方法。方法：12只中华小型猪分别采用ICE、TTE及MSCT测量主动脉瓣环直径,比较三种方法测量的准确性和一致性,以及三种方法测量结果在人工瓣膜型号选择方面的差异。结果：ICE、TTE和MSCT测量的瓣环直径分别为（23.69±0.83）mm、（22.91±1.11）mm和（23.81±0.76）mm,测量结果之间具有显著的差异（配对t检验）。不过Bland-Altman分析的结果提示TTE测量的结果较MSCT有显著的偏小趋势（差值均数：-0.91 mm,一致性界限：-2.78~0.97 mm）,而ICE不存在这种趋势。使用三种方法指导人工瓣膜型号选择时,ICE结果与MSCT有很好的一致性（Kappa=1.000）,而TTE选择的瓣膜尺寸在33.3%（4/12）的动物较MSCT结果偏小一个型号。结论：对于经导管主动脉瓣膜植入手术术前的主动脉瓣环测量,ICE与MSCT的结果一致性更好,TTE的结果则有低估瓣环直径的趋势,在一定的瓣膜选择策略下,ICE与MSCT的结果对瓣膜的选择具有很好的一致性,而TTE的结果易造成人工瓣膜的型号偏小。
Objective：To compare 3 commonly used imaging techniques as intra-cardiac echocardiography（ICE）,transthoracic echocardiography（TTE） and multiple slice computed tomography（MSCT） for measuring aortic annulus diameter in Chinese miniature pigs in order to find the best method for choosing prosthetic valve size in transcatheter aortic valve implantation（TAVI） in clinical practice.Methods：The aortic annulus diameters were measured in 12 Chinese miniature pigs by ICE,TTE and MSCT techniques respectively.The accuracy and consistency of each method was compared and the differences of 3 measurements were studied.Results：The mean aortic annulus diameter measured by ICE,TTE and MSCT were（23.69 ± 0.83） mm,（22.91 ± 1.1） mm and（23.81 ± 0.76） mm respectively,there were significant differences by t paired test from one another.However,Bland-Altman analysis indicated that compared with MSCT,TTE measurement had a tendency for under-estimation with the mean differenceof（-0.91） mm and limits of agreement at（-2.78 to 0.97） mm;while ICE measurement had no such tendency.When choosing the size of transcatheter valves,there was a good consistency between ICE and MSCT（kappa = 1.000）,in contrast,the size measured by TTE was 33.3%（4/12） smaller than MSCT.Conclusion：For measuring the diameter of aortic annulus before the operation,TAVI,ICE and MSCT has good consistency,while TTE has the tendency for underestimating the diameter of aortic annulus in experimental Chinese miniature pigs.
出处
《中国循环杂志》
CSCD
北大核心
2015年第5期482-486,共5页
Chinese Circulation Journal
