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目的应用电子束 CT(EBCT)观察 Amplatzer 房间隔缺损封堵器(ASO)置入后形态变化。方法 11例继发孔型房间隔缺损(ASD)患者,于封堵术后第1 d、3、6及12个月时行心电门控单层容积扫描,依据心脏解剖和 ASO 形态,选择3个观察层面,分别测量 ASO 左、右心房盘横径、腰部厚度和横径等指标;同时观察 ASO 的形态和位置随时问的变化。结果术后3、6和12个月时,分别有8、8和4例完成复查。ASO 在术后3或6个月时形态变化较大,与术后次日相比,主要是腰部厚度显著缩小(10例),术后1 d、3、6和12个月时 ASO 腰部厚度分别为(13.79±4.63)、(7.02±3.17)、(6.65±2.76)和(5.08±2.82)mm(P<0.05);左心房盘横径术后1 d、3、6和12个月时分别为(40.91±8.55)、、(39.04±13.10)、(39.45±13.20)和(44.79±5.27)mm,右心房盘横径术后1 d、3、6和12个月时分别为(37.24±4.98)、(36.54±4.83)、(37.01±4.73)和(39.56±5.88)mm,腰部横径术后1 d、3、6和12个月时分别为(21.55±5.82)、(22.80±4.88)、(20.52±5.82)和(27.72±4.53)mm,左、右心房盘和腰部横径变化不显著(P>0.05)。术后3、6和12个月时,分别有6、7和4例患者的 ASO 形态为优或良。在形态变化的同时,ASO 位置发生变化。结论 EBCT 能够直观、准确观察 ASO 各径线、形态和空间位置的变化过程。
Objective To observe the morphological changes after implantation of Amplatzer atrial septal defect occluder (ASO) by electron beam computed tomography (EBCT). Methods Eleven patients with ASD were performed ECG-monolayer volume scan at day 1, 3, 6, and 12 after closure. According to the anatomy of the heart and ASO morphology, Three observational levels were measured ASO left and right atrial diameter, waist thickness and diameter and other indicators; at the same time observe the morphology and location of ASO changes over time. Results At 3, 6 and 12 months after operation, 8, 8 and 4 cases were completed. ASO at 3 or 6 months after surgery morphological changes larger, and the day after surgery, mainly the waist thickness was significantly reduced (10 cases), 1 d, 3,6 and 12 months after the ASO waist thickness Were (13.79 ± 4.63), (7.02 ± 3.17), (6.65 ± 2.76) and (5.08 ± 2.82) mm respectively (P <0.05). Left atrial diameter at 1 d, 3, 6 and 12 months after operation (39.95 ± 13.20) and (44.79 ± 5.27) mm, respectively. The diameter of the right atrium at 1, 3, 6 and 12 months after operation were (37.24 ± 4.98, 36.54 ± 4.83, 37.01 ± 4.73 and 39.56 ± 5.88 mm respectively. The lumbar transverse diameters were (21.55 ± 5.82), (22.80 ± 4.88), (20.52 ± 5.82) and (27.72 ± 4.53) mm respectively. There was no significant difference in the diameter of the left and right atrium and lumbar between the two groups (P> 0.05). At 3, 6, and 12 months postoperatively, 6, 7 and 4 patients, respectively, had superior or good ASO morphology. At the same time as the morphological changes, the position of ASO changed. Conclusion EBCT can intuitively and accurately observe the changes of ASO diameter, shape and spatial location.