经导管关闭窦静脉缺损后的四维血流磁共振成像评估

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
C. Batteux, S. Hascoet, G. Albenque, A. Azarine, G. Reverdito
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引用次数: 0

摘要

导言最近出现了用有盖支架经导管矫正窦静脉缺损(SVD)的方法,并取得了良好的效果,成为手术的替代方案。方法自2023年5月以来,我们使用1.5T磁铁对16名接受经导管修复SVD的患者进行了心脏磁共振(CMR)扫描,包括4D血流磁共振序列。所有患者都获得了平衡稳态自由前扑(bSSFP)ctine 图像,用于评估左心室和右心室(RV)的容积和功能。通过视觉和定量分析,该研究的总体目标是检测异常血流模式和持续性分流(PS)的位置。此外,还测量了肺-系统血流比(Qp/Qs)和 RV 舒张末期容积指数(RVEDVi)。结果CMR 和 4D Flow MR 是可行的,并评估了所有 16 名患者手术的总体成功率。所有患者的 RVEDVi 均有所下降。16 名患者中有 12 名(75%)没有明显的 PS,Qp/Qs < 1.5,其中 8 名患者没有任何 PS。四名患者的 Qp/Qs > 1.5 显示了明显的分流。PS 视觉分析为了解和分析 PS 的机制提供了宝贵的见解。四维血流磁共振成像准确识别了PS,并全面显示了其位置和机制,为其随访和进一步讨论再干预提供了有价值的信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
4D flow magnetic resonance imaging evaluation after transcatheter closure of sinus venosus defects

Introduction

Transcatheter correction of sinus venosus defects (SVD) with covered stent has recently emerged, with promising results, as an alternative to surgery. Our aim was to assess the feasibility and diagnostic value of 4D flow MRI in patients who underwent transcatheter repair of SVD.

Methods

Since may 2023, we scanned 16 patients who underwent transcatheter repair of SVD with cardiac magnetic resonance (CMR) including a 4D Flow MR sequence, using a 1.5T magnet. For all patients, balanced steady-state free precession (bSSFP) cine images were obtained for evaluation of left and right ventricle (RV) volumes and function. Coronal ECG-gated 4D flow MR sequences were performed, with complete thoracic coverage.

Global objective was, by a visual and quantitative analysis, to detect abnormal flow patterns and location of persistent shunts (PS). Pulmonary-to-systemic flow ratios (Qp/Qs) and RV end-diastolic volume indexed (RVEDVi) were also measured.

Results

CMR and 4D Flow MR were feasible and assessed global success of the procedure in all 16 patients. RVEDVi decreased in all patients. Average Qp/Qs was 1.24 (± 0.33), with RVEDVi of 77 mL/m2 21).

Qp/Qs measured by catheterization, 4D Flow MR and RV/LV stroke volume ratio were well correlated.

Twelve out of 16 patients (75%) had no significant PS with Qp/Qs < 1.5, including 8 patients without any PS at all. Four patients showed significant shunting with Qp/Qs > 1.5.

PS visual analysis provided valuable insights into the understanding and the mechanism analysis of the PS.

Conclusion

We demonstrated the feasibility of 4D Flow MRI in all patients who had undergone transcatheter correction of SVD. 4D flow MRI accurately identified PS with comprehensive visualization of their location and mechanism, providing valuable information for their follow-up and to further discuss reintervention.

Qp/Qs ratio assessment using 4D Flow data showed good correlation compared to other functional measurements.

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来源期刊
Archives of Cardiovascular Diseases
Archives of Cardiovascular Diseases 医学-心血管系统
CiteScore
4.40
自引率
6.70%
发文量
87
审稿时长
34 days
期刊介绍: The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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