主动脉根部CTA影像评估在主动脉瓣成形术中的应用价值

目的探索主动脉根部CT血管造影(CTA)在术前评估中的应用,并与二维超声数据对比,评价两者与术中外科测量数据的相关程度。方法回顾性分析2018年1月至2020年8月期间,在我院行主动脉瓣成形术的53例主动脉瓣病变患者的临床资料,其中男38例、女15例,年龄10~77(42.9±18.3)岁。收集术前经胸二维超声和主动脉根部CTA对主动脉根部测量的数据,包括主动脉瓣环(AVA)、主动脉窦(Sinus)、窦管交界(STJ)。通过与术中实际测量的数据比较,做一致性分析。结果术前心脏超声AVA测量值和术前CT AVA测量值与术中AVA测量值均呈正相关(P<0.001)。与术前心脏超声AVA测量值相比相关系数(ρ)=0.74,均方误差(MSE)=12.78],术前CT AVA测量值保持了较高准确性,以及与术中AVA测量值的一致性(ρ=0.95,MSE=2.72)。在与术中AVA测量值的相关系数方面,术前CT高于经胸二维超声(P<0.001)。结论和经胸二维超声相比,主动脉根部CTA应用于主动脉瓣成形的术前评估数据,与外科术中实际测量的数据具有更高的一致性和准确性。

Value of aortic root CTA assessment in aortic valve surgery

Objective To evaluate the data of preoperative aortic root CT angiography(CTA),compare it with two-dimensional transthoracic echocardiography and investigate the correlation of the two measurements with the actual intraoperative measurement data.Methods Clinical data of 53 patients with aortic valve diseases who underwent aortic valve repair in our hospital from January 2018 to August 2020 were retrospectively analyzed,including 38 males and 15 females with an average age of 42.9±18.3 years ranging from 10 to 77 years.Preoperative two-dimensional transthoracic echocardiography(TTE)and aortic root CTA measurements were collected,including aortic valve annulus(AVA),aortic sinus(Sinus)and sino-tubular junction(STJ).In comparison with the intraoperative measurements during the aortic valve repair surgery,the consistency analysis was performed.Results Both the preoperative echocardiography AVA measurements and the CT AVA measurements were positively correlated with the intraoperative AVA measurements(P<0.001).Compared with the echocardiography AVA datacorrelation coefficient(ρ)=0.74,mean squared error(MSE)=12.78],the CT AVA data were more accurate and consistent with the intraoperative AVA measurements(ρ=0.95,MSE=2.72).CT AVA data had a higher correlation coefficient with the intraoperative measurements,compared to that of the echocardiography AVA data(P<0.001).Conclusion In comparison with two-dimensional transthoracic echocardiography,preoperative morphological evaluation of aortic root CTA is more consistent with the actual intraoperative measurements during aortic valve repair surgery.