Contrast-Enhanced C-Arm CT Evaluation of Radiofrequency Ablation Lesions in the Left Ventricle

التفاصيل البيبلوغرافية
العنوان: Contrast-Enhanced C-Arm CT Evaluation of Radiofrequency Ablation Lesions in the Left Ventricle
المؤلفون: Teri Moore, Amin A. Al-Ahmad, Günter Lauritsch, Jarrett Rosenberg, Jan Dr. Boese, Erin Girard, Richard Luong, Rebecca Fahrig
المصدر: JACC: Cardiovascular Imaging. 4(3):259-268
بيانات النشر: Elsevier BV, 2011.
سنة النشر: 2011
مصطلحات موضوعية: medicine.medical_specialty, Time Factors, Radiofrequency ablation, Swine, medicine.medical_treatment, Heart Ventricles, Iohexol, Contrast Media, Catheter ablation, 030204 cardiovascular system & hematology, arrhythmia, Article, 030218 nuclear medicine & medical imaging, law.invention, Lesion, 03 medical and health sciences, Necrosis, 0302 clinical medicine, law, Predictive Value of Tests, catheter ablation, medicine, Fluoroscopy, Animals, Radiology, Nuclear Medicine and imaging, medicine.diagnostic_test, business.industry, imaging, computed tomography, Equipment Design, Cardiac Ablation, Ablation, electrophysiology, Radiology Nuclear Medicine and imaging, Radiographic Image Interpretation, Computer-Assisted, Regression Analysis, Female, Radiology, Tomography, medicine.symptom, Nuclear medicine, business, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, medicine.drug, C-arm computed tomography
الوصف: Objectives The purpose of this study was to evaluate use of cardiac C-arm computed tomography (CT) in the assessment of the dimensions and temporal characteristics of radiofrequency ablation (RFA) lesions. This imaging modality uses a standard C-arm fluoroscopy system rotating around the patient, providing CT-like images during the RFA procedure. Background Both cardiac magnetic resonance (CMR) and CT can be used to assess myocardial necrotic tissue. Several studies have reported visualizing cardiac RFA lesions with CMR; however, obtaining CMR images during interventional procedures is not common practice. Direct visualization of RFA lesions using C-arm CT during the procedure may improve outcomes and circumvent complications associated with cardiac ablation procedures. Methods RFA lesions were created on the endocardial surface of the left ventricle of 9 swine using a 7-F RFA catheter. An electrocardiographically gated C-arm CT imaging protocol was used to acquire projection images during iodine contrast injection and after the injection every 5 min for up to 30 min, with no additional contrast. Reconstructed images were analyzed offline. The mean and SD of the signal intensity of the lesion and normal myocardium were measured in all images in each time series. Lesion dimensions and area were measured and compared in pathologic specimens and C-arm CT images. Results All ablation lesions (n = 29) were visualized and lesion dimensions, as measured on C-arm CT, correlated well with postmortem tissue measurements (linear dimensions: concordance correlation = 0.87; area: concordance correlation = 0.90. Lesions were visualized as a perfusion defect on first-pass C-arm CT images with a signal intensity of 95 HU lower than that of normal myocardium (95% confidence interval: −111 HU to −79 HU). Images acquired at 1 and 5 min exhibited an enhancing ring surrounding the perfusion defect in 24 lesions (83%). Conclusions RFA lesion size, including transmurality, can be assessed using electrocardiographically gated cardiac C-arm CT in the interventional suite. Visualization of RFA lesions using cardiac C-arm CT may facilitate the assessment of adequate lesion delivery and provide valuable feedback during cardiac ablation procedures.
تدمد: 1936-878X
DOI: 10.1016/j.jcmg.2010.11.019
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fb4c5da37cfd5203a4606b457279a348
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....fb4c5da37cfd5203a4606b457279a348
قاعدة البيانات: OpenAIRE
الوصف
تدمد:1936878X
DOI:10.1016/j.jcmg.2010.11.019