实时三维经胸超声心动图测量缩流面积评价主动脉瓣反流

Assessment of aortic regurgitation via real time three dimensional transthoracic echocardiographic measurements of vena contracta area

目的应用实时三维经胸超声心动图（3D-TTE）测量缩流面积（VCA）评价主动脉瓣反流。方法将56例主动脉瓣反流患者的三维测量的VCA以及二维经胸超声心动图（2D-TTE）测量的缩流宽度与主动脉根部造影和外科手术的主动脉瓣反流程度相比较。结果3D—TTE测得的VCA与主动脉根部造影和外科手术的主动脉瓣反流程度密切相关（r=0．95），无明显重叠。2D—TTE测得的缩流宽度亦与主动脉根部造影和手术的主动脉瓣反流程度有很好的相关性（r=0．92），但有较多的重叠。以主动脉根部造影和外科手术为主动脉瓣反流程度的标准，三维测得的1～4度主动脉瓣反流的相应VCA分别为≤0．19cm^2，0．2～0．39cm^2，0．4～0．59cm^2，≥0．6cm^2。结论实时3D—TTE彩色多普勒能准确评价主动脉瓣反流，且和主动脉根部造影有很好的相关性。

Objective To assess the aortic regurgitation （AR） via real-time three dimensional transthoracic echocardiographic （31）-TrE） measurements of vena contracta area （VCA）.Methods Fifty-six patients with of AR were included in this study. Assessments of AR via aortic root angiography and surgery were compared to 3D-TTE measurement of VCA and two dimensional transthoraoic echocardiographic（2D-TTE） measurement of vena contracta width （VCW）. Results V CA from 3D-TTE closely correlated with angio- graphic grade （ r =0.95） without significant overlap. VCW from 2D-TTE also favorably correlated with angiographic grade but with more overlaps（ r =0.92）. VCA of less than 0.2 cm^2 corresponded to grade 1, 0.2-0.39 cm^2 to grade 2, 0.4-0.59 cm^2 to grade 3, and an area of equal to or more than 0.6 cm^2 to grade 4 AR by angiography and surgery. Conchusion Real time 3D-TrE can accurately evaluate aortic valve reflux and has a good correlation with aortic root angiography.