超声心动图实时三平面成像法测量左心室容积的研究

Real-time tri-plane echocardiography for quantifying left ventricular volume in vitro and in vivo

目的在心室腔变形情况下,以注水法实测值为“金标准”,探讨实时三平面成像法(Tri-plane)测量左心室容积的准确性。若Tri-plane法可以准确测量左心室容积,则以其测值为标准,检验双平面Simpson法(2DE-Simpson)测量左心室容积的准确性。方法①在8个模拟左心室室壁瘤的橡胶水囊中(A组),应用Tri-plane法同步采集其三个互成60°角的长轴观图像,手动勾画上述切面观内膜边界测量左心室容积。以注水法实测容积作为“金标准”,将Tri-plane法容积测值与之比较。②在16个存在左室节段性室壁运动异常(RWMA)冠心病患者中(B组),应用Tri-plane法同步采集其心尖四腔观、心尖二腔观及心尖左室长轴观图像,手动勾画上述三个切面观心内膜边界测量左室舒张末期容积(LVEDV)和收缩末期容积(LVESV);同时应用2DE-Simpson法测量LVEDV和LVESV。以Tri-plane法所测容积值作为标准,将2DE-Simpson法容积测值与之比较。结果A组,Tri-plane法容积测值和实测左室容积呈高度正相关(r=0.982),且两者差异无统计学意义(P>0.05)。B组,2DE-Simpson法所测LVEDV和LVESV均低于Tri-plane法测值,其差异均有统计学意义(均P<0.05)。结论在心腔变形情况下,Tri-plane法可准确地测量左心室容积;而2DE-Simpson法测量左心室容积会造成容积的低估。Tri-plane法在容积测量方面较2DE-Simpson法更具优势。

Objective ①To evaluate the accuracy of real-time three-plane echocardiography （tri-plane） for quantifying left ventricular volume （LVV） in aneurismal balloons. ②To verify the accuracy of two-dimensional echocardiography using Simpson＇s method （2DE-Simpson） for quantifying LVV in cases with regional wall movement abnormal （RWMA）. Methods ①Tri-plane were performed in 8 aneurismal balloons （group A）. The LVV of aneurismal balloons were measured by triplane. The true LVV were measured by drained water, which served as a reference standard. The LVV by tri-plane were compared to the true volume. ②Tri-plane and 2DE were performed in 16 cases with RWMA （group B）. The LVEDV and LVESV by tri-plane were measured, which served as a reference standard. The LVEDV and LVESV by 2DE-Simpson were compared to that by tri-plane separately. Results ①in group A, there were an excellent correlation between LVV by triplane and the true LVV （r=0. 982）. There were no significant difference between them （P〉0.05）. ②In group B, LVEDV and LVESV by 2DE-Simpson are less than that by tri-plane, and there were a significant difference between them （P〈 0.05）. Conclusion Tri-plane can accurately quantify LVV and the method is superior to 2DE-Simpson in evaluating the volume of LV with abnormal left ventricular shape.