Objective To evaluate two kinds of practical CT three-dimensional volumetric measurement techniques in assessing atrial septal defects (ASDs) for transcatheter device closure. Methods Retrospective assessment of 50 consecutive patients who underwent ASD closure was conducted.Cardiac CT was performed in them before planned transcatheter ASD closure and postoperative chest radiograph was performed in both posteroanterior and lateral view.Coronary CT angiography was made for the detection of coronary artery disease,and three-dimensional reconstruction of ASD was conducted for determination of the defect size in the GE-workstation.Two kinds of practical CT three-dimensional volumetric measurement techniques,one named CT virtual endoscopy assisted volumetric measurement (CTVE) and another called axial sequence assisted volumetric measurement (CTAS),were used to calculate the major axis and the minor axis of the ASD respectively.Thus,the dimensions of the Equivalent Circle were derived,with circumference and area equal to the elliptic ASD according to the formulation (D= b4/a2+ a2-b2).The ASDs occluder (ASO) dimension was measured in the lateral chest radiograph,and this postoperative occluder-waist size (POS) value was regarded as the gold standard for the measurement of ASD.The results were compared between CTVE and CTAS,and the correlations were evaluated between them and the gold standard. Results The differences in the major dimensions (-9.05 mm,t=-6.60,P<0.05),minor dimensions (-4.86 mm,t=-4.39,P<0.05) and Equivalent circle dimensions (-7.65 mm,t=-6.40,P<0.05) of ASD between CTAS and CTVE were statistically significant.Though the CTAS cannot provide the en face views of ASDs,the Equivalent Circle dimensions measured by CTAS (22.48±5.59) mm was correlated well with POS (27.07±6.83) mm (Y=1.14X+ 1.39,r=0.94,P<0.01),and a good correlation was found between this Equivalent Circle dimensions and ASO size (Y=1.02X+ 6.84,R 2=0.78,r=0.88,P<0.05).The correlation between the Equivalent Circle dimensions measured by using CTVE (30.13±9.27) mm and POS was poor (Y=0.30X+ 17.94,r=0.41,P<0.01),though it can provide the en face views of ASDs. Conclusion CTVE and CTAS are two complementary techniques of assessing ASDs for transcatheter device closure. Key words: Heart septal defects,atrial; Heart catheterization; Septal occluder device; Imaging three-dimensional; Tomography,X-ray computed
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