背景:通过评估对比增强CT测量的参数与经胸超声心动图的TR严重程度之间的关系,来检查在对比增强计算机断层扫描(CT)上是否可以进行功能性三尖瓣反流(FTR)的形态学评估。
方法:50例患者行CT增强扫描。三尖瓣环区(TAA),三尖瓣环围(TAC),右心室容积(RVV),在舒张期和收缩期,在对比增强CT上测量了乳头状肌的尖端和底部之间的距离。50例分为TR≤轻度组34例(无TR:3例,琐碎的TR:24例,轻度TR:7例),TR≥中度组16例(中度TR:8例,重度TR:8例)使用经胸超声心动图测量的TR等级,然后检查各组之间的差异。
结果:在TAA中发现了显着差异,TAC,和RVV(p<0.01)以及舒张期和收缩期前后乳头状肌尖端之间的距离(p<0.05)。由于18例(36.0%)无法识别间隔乳头状肌,在所有情况下,仅可测量前乳头状肌和后乳头状肌之间的距离。关于接收器工作特性(ROC)曲线分析,TAA的ROC曲线下面积(AUC),TAC,和RVV均>0.7,dRVV的最大AUC为0.925。
结论:TAA,TAC,RVV,并且在TR≥中度组中,在对比增强CT上测得的前和后乳头状肌尖之间的距离显着增加。通过对比增强CT可以对FTR进行详细的形态学评估。
BACKGROUND: Whether it is possible to perform morphological evaluation of functional tricuspid regurgitation (FTR) on contrast-enhanced computed tomography (CT) was examined by evaluating the relationships between the parameters measured on contrast-enhanced CT and TR severity on transthoracic echocardiography.
METHODS: Fifty patients underwent contrast-enhanced CT. Tricuspid annulus area (TAA), tricuspid annulus circumference (TAC), right ventricular volume (RVV), and the distances between the tips and bases of the papillary muscles were measured on contrast-enhanced CT in diastole and systole. The 50 cases were divided into 34 in the TR ≤ mild group (no TR: 3 cases, trivial TR: 24 cases, mild TR: 7 cases), and 16 in the TR ≥ moderate group (moderate TR: 8 cases, severe TR: 8 cases) using the TR grade measured by transthoracic echocardiography, and then differences between the groups were examined.
RESULTS: Significant differences were found in TAA, TAC, and RVV (p < 0.01) and the distances between the tips of the anterior and posterior papillary muscles (p < 0.05) in both diastole and systole. Since the septal papillary muscle could not be identified in 18 cases (36.0%), only the distance between the anterior and posterior papillary muscles was measurable in all cases. On receiver-operating characteristic (ROC) curve analysis, the areas under the ROC curves (AUCs) of TAA, TAC, and RVV were all > 0.7, and the maximum AUC was 0.925 for dRVV.
CONCLUSIONS: TAA, TAC, RVV, and the distance between the tips of the anterior and posterior papillary muscles measured on contrast-enhanced CT were shown to be significantly increased in the TR ≥ moderate group. Detailed morphological assessment of FTR is possible by contrast-enhanced CT.