动态三维超声测量心肌梗死后左心室容积的实验研究

Three-dimensional echocardiography for quantifying left ventricular volumes in canine after coronary occlusion

目的:研究动态三维超声(3DE)测量急性心肌梗死(AMI)后左心室舒张末期容积(INEDV)的准确性和重复性。方法:以注水法测量的左心室容积(LVV)为标准,分别应用二维超声(2DE)Simpson法和3DE旋转法测量11只犬冠状动脉结扎4 h后的LVEDV,对比两种方法测量的准确性。结果:①3DE和2DE测量的LVEDV与注水法测量的LVV均高度相关,相关系数分别为0.98和0.87,标准估计误差(SEE)分别为1.69 ml和4.62 ml。②不同测量者和同一测量者不同时间应用3DE测量的LVEDV之间差异无显著性意义;中位数(MD)分别为0.88 ml和1.16 ml,均P>0.05。结论:与2DE相比,3DE能更准确测量LVV,且不受心室壁运动异常引起左心室变形情况的影响;3DE测量LVV具有良好的重复性。

Objective : This study was designed to compare the accuracy of three- and two-dimensional echocardiography for quantifying left ventricular end-diastolic volumes (LVEDV) , and to test the reproduc-ibility of three-dimensional echocardiography for measurement of LVEDV. Methods:Coronary ligation was performed in 11 open chest dogs. Two-and three-dimensional echocardiography were performed to measure LVEDV 4 hours after coronary occlusion, and the results were compared with those of fluid method. The three-dimensional echocardiographic date set was processed, and quantitative dates were derived weeks apart for evaluating intraobserver variability. Another investigator analyzed the date for obtaining interob-server variability. Results:Three-dimensional echocardiographic measurements of LVEDV correlated more closely with LW of fluid method ( r = 0. 98, SEE±1. 69 ml) than did the two-dimensional Simpson' s method ( r = 0. 87, SEE±4.62 ml). Analysis of intra- and interobserver variability showed strong indexes of agreement in the measurement of LVEDV with three-dimensional echocardiography. Conclusion: For geometrically asymmetric left ventricular volumes associated with acute myocardial infarction, volume-rendered three-dimensional echocardiography can quantitatively measure left ventricular volume.