基于三维经食管超声心动图数据的左心耳3D打印模型的准确性研究

Accuracy of left atrial appendage 3D printing model based on three-dimension transesophageal echocardiography data

目的应用三维经食管超声心动图(3D-TEE)数据重建并打印心房颤动患者左心耳3D模型,分析其准确性。方法选取行3D-TEE及心脏增强CT检查的心房颤动患者20例,对其3D-TEE左心耳数据进行后处理,使用软质类橡胶材料打印3D实体模型,测量左心耳模型的开口长径、开口短径、深度并评估解剖分型,将其与3D-TEE、CT测量结果进行比较及一致性分析。结果3D模型与3D-TEE测量左心耳开口长径、开口短径、深度比较差异均无统计学意义;3D模型与3D-TEE测量左心耳开口长径、开口短径、深度的ICC分别为0.97、0.98、0.98。3D模型、3D-TEE测量左心耳开口长径、开口短径、深度均小于CT,差异均有统计学意义(均P<0.05);3D模型与CT测量左心耳开口长径、短径、深度的ICC分别为0.91、0.90、0.90,3D-TEE与CT测量左心耳开口长径、开口短径、深度的ICC分别为0.91、0.88、0.90。3D模型与CT在评估左心耳形态、分叶方面比较差异均无统计学意义;两种技术评估左心耳形态、分叶的一致性均很高(Kappa=0.86、0.91,均P<0.05)。3D-TEE与CT在评估左心耳形态、分叶方面比较差异均无统计学意义;两种技术评估左心耳形态的一致性较高(Kappa=0.71,P<0.05),评估左心耳分叶的一致性很高(Kappa=0.81,P<0.05)。结论基于3D-TEE数据的3D打印模型可准确还原心房颤动患者左心耳各径线数据;与3D-TEE相比,3D模型在评估左心耳形态及分叶方面与CT重建一致性更高。

Objective To analyze the accuracy of the left atrial appendage(LAA)3D printing model based on three dimension transesophageal echocardiography(3D-TEE)performed on patients with atrial fibrillation.Methods Twenty patients with atrial fibrillation underwent both 3D-TEE and contrast-enhanced cardiac CT were selected.The 3D-TEE data of the LAA were post-processed,and 3D solid models were printed using soft rubber-like materials.The LAA orifice long axis and short axis,and depth were measured,and anatomical classification was evaluated.The results was compared with 3D-TEE and CT,and the consistency analysis was performed.Results There were no statistically significant differences of the LAA orifice long axis,short axis,and depth between the 3D model and 3D-TEE measurements.The intraclass correlation coefficients(ICC)for long axis,short axis,and depth of LAA between the 3D model and 3D-TEE were 0.97,0.98,0.98,respectively.The measurements of the LAA long axis,short axis,and depth obtained by 3D model and 3D-TEE were lower than those measured by CT,and the differences were statistically significant(all P<0.05).The ICC between 3D model and CT for the LAA long axis,short axis,and depth were 0.91,0.90,0.90,respectively.The ICC between 3D-TEE and CT for the LAA long axis,short axis,and depth were 0.91,0.88,0.90,respectively.There were no statistically significant differences between the 3D model and CT in assessing LAA morphology and lobes.Both technologies demonstrated high consistency in assessing LAA morphology and lobes(Kappa=0.86,0.91,both P<0.05).There were no statistically significant differences between 3D-TEE and CT in assessing LAA morphology and lobes.Both technologies demonstrated moderate consistency in assessing LAA morphology and high consistency in assessing LAA lobes(Kappa=0.71,0.81,both P<0.05).Conclusion 3D printed LAA models based on TEE data can accurately reproduce the dimensional data of patients with atrial fibrillation.Compared with 3D-TEE,3D LAA models show higher consistency with CT reconstructions in assessing morphology and lobes.