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三种影像学测量技术对左心耳封堵器尺寸选择的指导价值 被引量:10
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作者 刘阁 陈韬 +6 位作者 穆洋 韩宝石 朱航 汪奇 郭豫涛 陈韵岱 郭军 《协和医学杂志》 CSCD 2020年第1期21-26,共6页
目的初步探讨CT血管造影(CT angiography,CTA)、经食管超声心动图(transesophageal echocardiography,TEE)和术中数字减影血管造影(digital subtraction angiography,DSA)3种方法测量左心耳开口直径对选择适宜尺寸左心耳封堵器的指导价... 目的初步探讨CT血管造影(CT angiography,CTA)、经食管超声心动图(transesophageal echocardiography,TEE)和术中数字减影血管造影(digital subtraction angiography,DSA)3种方法测量左心耳开口直径对选择适宜尺寸左心耳封堵器的指导价值。方法回顾性收集2015年12月1日至2019年3月31日在解放军总医院第一医学中心接受经皮左心耳封堵术的非瓣膜性房颤患者临床资料。所有入选患者同时采用CTA、TEE、DSA 3种方法测量左心耳开口直径,记录植入封堵器尺寸,采用Pearson相关性分析比较3种方法测量值与植入封堵器尺寸的相关性,采用BlandAltman一致性分析法比较3种方法测量值与所植入封堵器尺寸的一致性。结果共102例符合纳入和排除标准的患者入选本研究,均成功植入WATCHMAN封堵器。平均年龄(70.1±9.8)岁,CHA2DS2-VASc评分(评估非瓣膜性房颤成年患者发生卒中的风险)为(5.11±1.43)分,HAS-BLED评分(评估出血风险)(3.61±1.18)分。CTA测量左心耳开口直径[(22.51±3.55)mm]与DSA[(22.22±3.73)mm]接近,无统计学差异(q=0.81,P=0.12),两种方法的测量值均大于TEE[(20.82±0.36)mm,P均<0.01]。封堵器尺寸与CTA、DSA、TEE测量的左心耳开口直径呈正相关(r=0.93、0.87、0.83,P均<0.01)。封堵器尺寸与CTA测量值的一致性界限最窄(-7.83 mm,-2.56 mm),差值为(-5.19±1.35)mm,95%置信区间为(-5.46 mm,-4.93 mm);与TEE测量值的一致性界限最宽(-11.00 mm,-2.77 mm),差值为(-6.88±2.10)mm,95%置信区间为(-7.29 mm,-6.47 mm)。结论CTA、DSA、TEE测量左心耳开口直径能为选择左心耳封堵器适宜尺寸提供较好依据,其中CTA测量值与封堵器尺寸的相关性和一致性最佳。 展开更多
关键词 房颤 左心耳封堵术 CT血管造影 经食管超声心动图 数字减影血管造影
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Optical coherence tomography assessment of edge dissections after drug-eluting stent implantation in coronary artery 被引量:5
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作者 GUO Jun CHEN Yun-dai +9 位作者 TIAN Feng LIU Hong-bin CHEN Lian SUN Zhi-jun REN Yi-hong JIN Qin-hua LIU Chang-fu han bao-shi GAI Lu-yue YANG Ting-shu 《Chinese Medical Journal》 SCIE CAS CSCD 2012年第6期1047-1050,共4页
Background Edge dissections after coronary stent implantation are associated with increased short-term risk of major adverse cardiovascular events. The incidence and outcome of edge dissections after coronary stent im... Background Edge dissections after coronary stent implantation are associated with increased short-term risk of major adverse cardiovascular events. The incidence and outcome of edge dissections after coronary stent implantation were reportedly different using different imaging techniques. We used optical coherence tomography (OCT) to assess the incidence, morphological findings and related factors of edge dissections after drug-eluting stent (DES) implantation. Methods Totally 42 patients with 43 de novo lesions in 43 native arteries undergoing DES implantation with OCT imaging were enrolled in this study. Results Nine edge dissections were detected in 43 arteries after DES implantation. There were four morphological patterns of stent edge dissections indentified in this study: (1) superficial intimal tears (n=3), (2) subintimal dissections (n=4), (3) split of media (n=1), (4) disruption of the fibrotic cap of plaque (n=1). Stent edge expansion and stent expansion were both higher in the group with dissections than those in the group without dissections (1.682±0.425 vs. 1.229±0.285, P=0.0290; 1.507±0.445 vs. 1.174±0.265, P=0.0072). Conclusions The incidence of stent edge dissections detected by OCT was 21%. Stent edge dissection is related with stent edge expansion and stent expansion. 展开更多
关键词 optical coherence tomography STENT dissections
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