64层螺旋CT及对比增强MR左心房成像与三维电解剖标测系统配准精确性的对比研究  

Comparative study of registration accuracy between 64-slice spiral CT and contrast enhanced MR in left atrium imaging for integrated cartography system

作　　者：卢春山[1] 张兆琪[2] 王珏[2] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029 [2]首都医科大学附属北京安贞医院医学影像科,100029

出　　处：《中华放射学杂志》2009年第8期809-812,共4页Chinese Journal of Radiology

摘　　要：目的探讨64层CT及对比增强MR左心房成像与左心房三维电解剖标测系统（CARTO）进行配准的可行性及精确性，并对其精确性进行对照分析。方法40例应用CARTO系统进行导管消融治疗的心房颤动患者分为2组，每组20例，分别于消融术前24h内行64层CT左心房成像及对比增强MR左心房成像。提取左心房64层CT及MR的DICOM数据输入CARTO系统，与电解剖取样标测得到的左心房轮廓进行整合配准，进而生成可指导心房颤动射频消融各项实时操作的清晰的左心房影像。分析所有样本、64层CT组及MR组的DICOM数据与CARTO系统所得出左心房轮廓的平均配准误差，并对64层CT组及MR组的配准误差采用配对样本t检验进行均差对比。结果64层CT组与MRI组均顺利完成了与CARTO系统的图像配准，生成了电解剖与影像解剖精确融合的左心房影像。所有样本、64层CT组及MR组数据的平均表面配准误差分别为（2．3±0．5）、（2．2±0．4）、（2．5±0．6）mm，表面配准误差均差分别为CT组（2．2±0．4）mm，MRI组（2．4±0．5）mm，2组差异无统计学意义（t=1．37，P=0．081）。结论64层CT与对比增强MRA左心房成像均可与CARTO系统精确配准，且在配准精确性方面无差异。Objective To evaluate the registration accuracy and the efficacy of integrated cartography （CARTO） system with 64 multislice spiral CT scan and contrast enhanced MRI for the assessment of left atrium （LA） geometry and to compare the registration accuracy between CT and MRI. Methods Forty consecutive patients with drug-refractory atrial fibrillatin （AF） underwent catheter ablation under the guidance of a three-dimensional （3D） CARTO system （Biosence Webster, Inc. , Diamond Bar, CA, USA）. Gadolinium-enhanced MRI （ 1.5 T, n = 20） and contrast-enhanced high-resolution CT （ 64-slice, n = 20） imaging were performed within 24 h prior to the ablation procedures. The DICOM data acquired by CT/ MRA were input into CARTO system and the LA images were extracted for CARTO image registration. Clinical AF ablation was quided by LA geometry. The registrated values of general samples, CT group, MR group were analyzed and comparison was made between CT and MR groups with the mean deviation of registrated values. Results The segmented 3D MRI and CT LA reconstructions were accurately registerted to the real-time mapping space with a combination of landmark registration and surface registration. The registered 3D CT and MR LA reconstruction were successfully used to guide deployment of RF applications encircling the pulmonary veins （PVs）. The distance between the surface of the registered LA reconstruction and multiple electroanatomic map points with an error of （2. 3 ± 0. 5 ） mm in general group, （2. 2 ± 0. 4） mm in CT group, and （2. 5 ± 0. 6 ） mm in MR group respectively. The mean deviation of the registration were （2. 2 ±0. 4） mm in CTA group and （2.4 ±0. 5） mm in MRA group respectively. There was no significant difference in the LA registration error between the two groups （t = 1.37, P = 0. 081 ）.Conclusions Both three-dimensional CT and MR images integrated into an CARTO system can be successfully used to perform catheter ablation for AF and there was no difference in

关 键 词：心房颤动 导管消融术 体层摄影术 X线计算机 磁共振成像 电生理学技术 心脏 

分 类 号：R686[医药卫生—骨科学]