经导管主动脉瓣置换术前实时三维经食管超声自动测量主动脉瓣环径

目的 探讨经导管主动脉瓣置入术（TAVR）中应用实时三维经食管超声心动图（3D-TEE）自动测量主动脉瓣环的可行性与准确性。方法 对21例拟接受TAVR患者于术前分别采用3D-TEE和多排CT（MDCT）测量主动脉瓣环面积、周长、最大径和最小径。对比3D-TEE测值与MDCT测值间的差异及相关性，记录3D-TEE自动测量主动脉瓣环参数所需的时间。结果 3D-TEE所测主动脉瓣环面积为（445.74±62.60）mm²，周长为（76.16±5.30）mm，最大径为（26.29±1.97）mm，最小径为（21.40±1.68）mm，MDCT测值分别为（456.85±75.70）mm²、（77.17±5.90）mm、（26.76±2.83）mm、（20.98±1.76）mm。MDCT与3D-TEE所测主动脉瓣环面积、周长、最大径及最小径差异均无统计学意义（P均>0.05）。3D-TEE与MDCT所测主动脉瓣环面积、周长、最大径、最小径均呈高度相关（r=0.89、0.91、0.85、0.79，P均<0.01）。采用3D-TEE自动测量主动脉瓣相关径线所需时间为（1.54±0.21）min。结论 3D-TEE自动测量主动脉瓣环能准确、快速获得主动脉瓣环相关径线，可作为替代MDCT的影像学方法。

Real-time three-dimensional transesophageal echocardiography automated measuring of aortic annulus before transcatheter aortic valve replacement

Objective To explore the feasibility and accuracy of 3D transesophageal echocardiography (3D-TEE) automated measuring of aortic annulus before transcatheter aortic valve replacement (TAVR). Methods The area, perimeter, maximal diameter and minimum diameter of aortic annulus were measured with 3D-TEE and multi-detector CT (MDCT) in 21 patients who underwent TAVR. The difference and correlation between the above parameters measured with 3D-TEE and MDCT were analyzed. The time for measuring aortic annulus with 3D-TEE was recorded. Results The area, perimeter, maximal diameter and minimum diameter of aortic annulus measured with 3D-TEE were (445.74±62.60)mm², (76.16±5.30)mm, (26.29±1.97)mm and (21.40±1.68)mm, respectively, with MDCT were (456.85±75.70)mm², (77.17±5.90)mm, (26.76±2.83)mm, (20.98±1.76)mm, respectively (all P>0.05), all had high correlations (r=0.89, 0.91, 0.85, 0.79, all P<0.01). The analyzed time was (1.54±0.21)min with automated 3D-TEE. Conclusion Automated measurement of aortic annular with 3D-TEE before TAVR is feasible, accuracy and rapid, which may replace MDCT for TAVR in clinical setting.