Abstract
Accurate anatomical and functional assessment of AV and aortic root is crucial to understand the pathophysiology of abnormalities and management decision-making in patient with aortic valve diease and aortic aneurysm. The aim of this study was to evaluate the feasibility of novel semi-automatic assessment of AV and aortic root from volumetric 3-D Echo compared to CT. Volume-rendered 3-D TEE data were obtained using V5M transducer(Sequoia, Siemens). 6 points(commisures and valve tips) at ED and ES were identified on the 3-D TEE data. Volumetric CT images were acquired using 64-Slice CT(Avanto, Siemens). A dynamic 3-D model of the AV and root were obtained by standard mathematical modeling approach (non-uniform rational B-splines). This enabled automatic visualization and quantification of AV and root. We measured phasic change of the AVA(cm2), diameter of sinotubular junction(d-STJ, mm), sinus of Valsalva(d-SV, mm) and basal ring(d-BR, mm). 364 CT volumes from 41 patients and 23, 3-D TEE volumes from 15 patients with normal to mild AR were acquired. 3-D TEE data about AV and root showed strong correlation with CT data(table ). Figure showed representative examples of 3-D Echo and CT modeling. This novel automated 3-D Echo approach provides accurate dimensions of the AV and the aortic root and may aid in valve and root repair procedures. Comparison of AVA and aortic diameter between 3-D TEE and CT Figure 1. Top; Aortic root model, Bottom; Aortic valve model Figure 2. Automatic calculation from 3D TEE data (left; AVA, right; Aortic root diameter) Figure 3. Aortic root model segmentation (left two; 3D TEE, right two; CT)
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