| 摘要: |
| 目的 探讨左心耳开口的多个解剖参数与术中最终置入房颤患者体内的LAmbreTM封堵器型号之间的关系。方法 选取23例于本院成功进行左心耳LAmbreTM封堵的心房颤动患者，应用Mimics软件对其左心耳3D TEE DICOM容积数据进行阈值分割等操作，重建左心耳三维(3D)模型，测量评估左心耳开口参数，并对比左心耳开口最大径、周长及面积与手术最终选择封堵器型号之间的相关性。制作两例术中更换封堵器患者的左心耳3D打印模型并进行体外封堵器释放实验。结果 成功对23例房颤病人的左心耳超声容积数据进行后处理并获取了包括左心耳开口形态在内的五个开口参数。左心耳开口最大径、面积和周长与相应LAmbreTM封堵器固定盘型号的相关性r值分别为0.85、0.74、0.89（均P＜0.001）。通过对左心耳开口参数的综合评估，体外实验中成功封堵了两例左心耳模型，且所选择的两个封堵器与手术最终应用的型号一致。结论 综合分析左心耳3D模型开口解剖参数可以更好地指导LAmbreTM封堵器型号的选择。 |
| 关键词: 左心耳封堵 型号 开口 超声心动描记术，经食管，三维 DICOM数据 |
| DOI： |
| 投稿时间：2018-02-12修订日期：2018-03-23 |
| 基金项目:国家自然科学基金项目（面上项目） |
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| A study of choosing occluder size of LAmbreTM using the parameters of left atrial appendage orifice from 3D model based on TEE data |
| Deng Qing,Zhou Qing |
| (Renmin Hospital of Wuhan University) |
| Abstract: |
| Objective This study aimed to explore the relationship between the parameters of the LAA orifice based on three-dimensional transesophageal echocardiography (3D TEE) data and the final decive size of LAmbreTM. Methods We retrospectively analyzed ultrasound 3D DICOM data from 23 patients who underwent LAA occlusion with the LAmbreTM occluder. The volume images of LAA were acquired by the post-processing of Mimics software. The parameters of the LAA orifice were measured and evaluated. Two cases of LAA who had been replaced occluders during LAA occlusion were printed, and simulation operations were carried out on these models. Results The data of 23 patients were successfully post-treated and five parameters of the LAA orifice were obtained. Correlation between the maximal width, area and perimeter measurements and the closure disk of the LAmbreTM device were r=0.85, P=0.000, r=0.74, P=0.000, r=0.89, P= 0.000, respectively. By comprehensive analysis of the LAA orifice parameters, the two occluders finally used for simulation were selected, which had the same size as the occluder chosen for the actual procedure, and were inserted into 3D printing models with a near perfect fit. Conclusions Comprehensive analysis of the anatomical parameters of the LAA orifice by ultrasound 3D DICOM data may better guide the choice of optimal device size LAmbreTM. |
| Key words: Left atrial appendage closure Size Orifice Echocardiography, transesophageal, three-dimensional DICOM data |
