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首页> 外文期刊>Acta Radiologica >Low radiation dose non-contrast cardiac CT: Is it of value in the evaluation of mechanical aortic valve
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Low radiation dose non-contrast cardiac CT: Is it of value in the evaluation of mechanical aortic valve

机译：低辐射剂量对比心脏CT：在机械主动脉瓣评估中的价值

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Background: Prosthetic bileaflet mechanical valve function has been traditionally evaluated using echocardiography and fluoroscopy. Multidetector computed tomography (MDCT) is a novel technique for cardiac evaluation. Purpose: To evaluate bileaflet mechanical aortic valves using a low-milliampere (mA), non-contrast MDCT protocol with a limited scan range. Material and Methods: Forty patients with a bileaflet mechanical aortic valve were evaluated using a non-contrast, low-mA, ECG-gated 64 MDCT protocol with a limited scan range. MDCT findings of opening and closing valve angles were correlated to fluoroscopy and echocardiography. Also, the valve visibility was evaluated on MDCT and fluoroscopy according to a 3-point grading scale. Results: The visualization score with the MDCT was significantly superior to the fluoroscopy (3 vs. 2.7). A strong correlation was noted between the opening (r = 0.82) and closing (r = 0.96) valve angles with MDCT and fluoroscopy without a statistically significant difference (P = 0.31 and 0.16, respectively). The mean effective radiation dose of the suggested protocol was 4±0.5 mSv. Five valves were evaluated using transesophageal echocardiography because the valves were difficult to evaluate with transthoracic echocardiography, and all of these valves were evaluated optimally with MDCT. A high-pressure gradient was noted in nine valves, and the MDCT showed that seven of these valves inadequately opened, and two valves opened well, which resulted in patient valve mismatch. Incomplete valve closure was noted in five valves, and the echocardiography showed significant transvalvular regurgitation in all five valves. Conclusion: MDCT can provide a precise measurement of valve function and can potentially evaluate high-pressure gradients and transvalvular regurgitation.
机译：背景：传统上，使用超声心动图和荧光透视技术评估假体双叶机械瓣膜功能。多探测器计算机断层扫描（MDCT）是一种用于心脏评估的新技术。目的：使用扫描范围有限的低毫安（mA），非对比MDCT方案评估双叶机械主动脉瓣。材料与方法：使用无造影剂，低mA，ECG门控的64 MDCT方案对有限的扫描范围进行评估，对40例具有双叶机械主动脉瓣膜的患者进行评估。 MDCT打开和关闭阀角度的发现与荧光检查和超声心动图相关。而且，根据三点分级量表在MDCT和荧光检查上评估了瓣膜的可见性。结果：MDCT的可视化评分显着优于荧光检查（3比2.7）。注意到在使用MDCT和荧光镜检查时，阀瓣开度（r = 0.82）和阀瓣闭度（r = 0.96）之间有很强的相关性，而无统计学差异（分别为P = 0.31和0.16）。建议方案的平均有效辐射剂量为4±0.5 mSv。经食道超声心动图评估了五个瓣膜，因为难以通过经胸超声心动图评估，并且所有这些瓣膜均通过MDCT进行了最佳评估。在九个阀门中发现了高压梯度，并且MDCT显示这些阀门中的七个没有充分打开，两个阀门很好地打开，从而导致患者阀门失配。在五个瓣膜中发现瓣膜关闭不完全，并且超声心动图显示在所有五个瓣膜中均存在明显的经瓣膜返流。结论：MDCT可以提供对瓣膜功能的精确测量，并且可以潜在地评估高压梯度和经瓣膜反流。

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