应用超声和CT 3D DICOM数据重建左心耳3D模型的对比研究  

Comparative study of 3D reconstruction of left atrial appendage model based on ultrasound and CT 3D DICOM data

作　　者：加丹 周青[1] 宋宏宁[1] 胡波[1] 陈金玲[1] 梅丹娥 邓倾[1] 谭团团[1] 

机构地区：[1]武汉大学人民医院超声科,430060

出　　处：《中华超声影像学杂志》2017年第6期484-489,共6页Chinese Journal of Ultrasonography

基　　金：湖北省卫生和计划生育委员会青年人才项目（WJ2017Q009）;中央高校科研专项基金重点重大培育项目（2042015kf1048）

摘　　要：目的通过对左心耳三维经食管超声心动图（3D-TEE）及心脏CT DICOM数据进行后处理，重建左心耳3D模型，评价及比较两种影像学技术作为3D打印数据源评估左心耳解剖参数的一致性。方法选取63例于本院就诊并接受3D-TEE及心脏CT检查的心房颤动患者，导出其左心耳原始DICOM数据。经Mimics软件的阈值分割等后处理操作重建左心耳容积图像，评估左心耳整体解剖形态及开口形态并测量其开口经线，对比分析3D-TEE和CT所得参数的差异，评价两种方法的一致性。结果成功对两种影像方法所得63例心房颤动患者数据进行后处理并获取左心耳详细解剖参数。形态参数：基于3D—TEE及CT数据评估左心耳整体解剖形态及开口形态的一致性Kappa值分别为91．0％、69．3％；测量参数：基于3D-TEE数据测量左心耳开口面积、周长、长径、短径及深径值均小于CT（均P〈0．05）。3D-TEE组和CT组的57例（90．5％）患者左心耳主叶有明显弯曲，测量该57例左心耳主叶第一转角及第一转角发出距离值差异均无统计学意义（均P〉0.05），Bland—Altman分析基于两种3D打印数据源的左心耳测量参数值一致性良好。结论3D-TEE可以作为左心耳的3D打印数据源，在左心耳空间解剖结构的评估中与CT具有较高的一致性。Objective To investigate the consistency of the anatomical parameters of left atrial appendage （LAA） based on three-dimensional transesophageal echocardiography （3D-TEE） and CT of 3D print datasource by the post-processing of DICOM data. Methods Sixty-three patients with atrial fibrillation in our hospital who underwent 3D-TEE and cardiac CT examination were selected and the original DICOM data of the LAA were obtained. The volume images of LAA were acquired by the postprocessing of Mimics software. After measuring and evaluating the anatomical parameters, the differences of parameters between TEE and CT were compared and the consistency of the two methods was evaluated. Results The data of 63 patients with atrial fibrillation obtained by 3D-TEE and CT were successfully post-treated and the detailed anatomical parameters of LAA were obtained. Morphological parameters：the Kappa values of the anatomical shape and opening shape of the LAA based on the 3D TEE and CT data were 91.0%,69.3%, respectively. Measurement parameters： the area, perimeter, long axis, short axis of ostiums of LAA, and depth of LAA by CT were larger than those by 3D-TEE（all P 〈0.05）. The post-processing results showed that 57 patients （90.5% ） had significant bending of LAA＇s main lobe in the 3D-TEE group and CT group, the difference in the measurements of the angle of the first bend and the distance from the first bend of the LAA to the orifice of the 57 cases between by 3D-TEE and CT were no statistical significance （ P 〉 0.05）. LAA＇ measurements of 3D-TEE was concordant well with CT＇s by Bland-Altman analysis. Conclusions In agreement with CT, 3D-TEE can also be used as a datasource for 3D printing by evaluating spatial morphology of the LAA.

关 键 词：超声心动描记术 经食管 三维 CT 左心耳 3D打印 

分 类 号：R540.45[医药卫生—心血管疾病] R541.75[医药卫生—内科学]