应用电子束CT评价Amplatzer房间隔缺损封堵器置入后形态变化

Assessment of changes in profile of Amplatzer septal occluder by electronic beam CT after deployed

目的应用电子束 CT(EBCT)观察 Amplatzer 房间隔缺损封堵器(ASO)置入后形态变化。方法 11例继发孔型房间隔缺损(ASD)患者,于封堵术后第1 d、3、6及12个月时行心电门控单层容积扫描,依据心脏解剖和 ASO 形态,选择3个观察层面,分别测量 ASO 左、右心房盘横径、腰部厚度和横径等指标;同时观察 ASO 的形态和位置随时问的变化。结果术后3、6和12个月时,分别有8、8和4例完成复查。ASO 在术后3或6个月时形态变化较大,与术后次日相比,主要是腰部厚度显著缩小(10例),术后1 d、3、6和12个月时 ASO 腰部厚度分别为(13.79±4.63)、(7.02±3.17)、(6.65±2.76)和(5.08±2.82)mm(P<0.05);左心房盘横径术后1 d、3、6和12个月时分别为(40.91±8.55)、、(39.04±13.10)、(39.45±13.20)和(44.79±5.27)mm,右心房盘横径术后1 d、3、6和12个月时分别为(37.24±4.98)、(36.54±4.83)、(37.01±4.73)和(39.56±5.88)mm,腰部横径术后1 d、3、6和12个月时分别为(21.55±5.82)、(22.80±4.88)、(20.52±5.82)和(27.72±4.53)mm,左、右心房盘和腰部横径变化不显著(P>0.05)。术后3、6和12个月时,分别有6、7和4例患者的 ASO 形态为优或良。在形态变化的同时,ASO 位置发生变化。结论 EBCT 能够直观、准确观察 ASO 各径线、形态和空间位置的变化过程。

Objective To assess the changes in profile of Amplatzer septal occluder by electronic beam computer tomography （EBCT） after deployed in patients with atrial septal defect, Methods ECG- gated single volume scanning was performed in 11 patients with atrial septal defects after the day that occluders were deployed. The same performance was repeated at 3, 6 and 12-month follow-up respectively. Diameters of the waist, the left retention disc, the right retention disc and thickness of the waist were measured respectively at three slices selected according to the cardiac anatomy and the profile of occluder. Results Reexaminations were performed in 8 patients at 3 and 6-month follow-up respectively and in 4 patients at 12-month follow-up. The changes in profile of occluder were remarkable at 3 and （ or ） 6-month follow-up. The major changes were shrinkage of the waist （n = 10 ）, and the thickness were （ 13.79±4. 63）, （7.02±3.17）, （6.65±2. 76）and （5.08±2. 82） mm at 3, 6 and 12-month follow-up respectively （ P 〈 0. 05 ）. No significant changes of diameters of left retention disc [ （ 40. 91 ± 8.55 ）, （ 39. 04 ± 13.10）, （ 39.45 ± 13.20 ） and （ 44. 79 ± 5.27 ） mm, P 〉 0. 05 ], right retention disc [ （ 37. 24 ± 4. 98 ）, （36. 54 ± 4. 83 ）, （ 37.01 ± 4. 73 ） and （ 39. 56 ± 5. 88 ） mm, P 〉 0. 05 ] and waist [ （ 21.55 ± 5.82 ）, （ 22. 80 ± 4. 88 ）, （ 20. 52 ± 5.82 ） and （ 27.72 ± 4. 53 ） nun, P 〉 0.05 ] was detected at 3, 6 and 12-month follow-up respectively. Profiles of 6 occluders at 3-month follow-up, 7 occluders at 6-month follow-up and 4 occluders at 12-month follow-up were considered to be optimal, respectively. Together with the changes in profile, the change of occluder position was detected. Conclusion EBCT is an optimal assessment tool which can demonstrate the changes in size, profile and position of the occluder after deployed.