“照相法”对二尖瓣手术标本瓣口面积的测量

A new method for measuring anatomic orifice area of mitral valve specimen

目的:探讨"照相法"测量二尖瓣手术标本瓣口面积(MVA)的方法。方法:在二尖瓣置换术患者20例术中取二尖瓣口标本并固定,用二维超声心动图(2DE)和实时三维超声心动图(RT-3DE)分别测量术前活体的MVA(MVA2DE和MVA3DE)、术后标本MVA(MVAOP2DE和MVAOP3DE)。将标本置入已定标的模具并拍照获取瓣口"鸟瞰图"。用软件测量"鸟瞰图"中标本MVA(MVAOP照)。结果:MVAOP照与MVA2DE、MVA3DE、MVAOP2DE、MVAOP3DE均呈高度相关(r分别为0.84,0.89,0.94和0.94,P<0.05),且MVAOP照与其他标本MVA测值间差异无统计学意义(P>0.05)。结论:"照相法"可简便、准确地测量二尖瓣手术标本MVA,为临床评价MVA提供了一种可靠的对照方法。

Objective：To explore the methodology and clinical value of measuring anatomic mitral valve orifice area by photography. Method：Twenty inpatients with rheumatic mitral stenosis were studied and their mitral valve specimens were acquired in mitral valve replacement surgery. The in vivo mitral valve orifice area （MVA） and anatomic mitral valve orifice area were respectively measured by two dimensional echocardiography （2DE） and real time three dimensional echocardiography （RT-3DE）. All the MVA were recorded, which were MVA2DE, MVA3DE, MVAoP2DE and MVAOP3DE. The specimens were located in the standardized mould and the bird＇s-eye photos were taken by photography. Using some software, the anatomic mitral valve orifice areas（MVAOP）were calculated. Result：There are high correlations between MVA2DE, MVA3DE, MVAOP2DE, MVAOP3DE and MVAOP （r= 0.84, 0.89, 0.94 and 0.94, P〈0.05）. Moreover, MVAOP and other anatomic MVA taken from echocardiography were no statistically significant differences （P〉0.05）. Conclusion： Photography can conveniently and accurately measure anatomic mitral valve orifice area, and provide a reliable contrast method for assessing mitral valve orifice area in clinical applications.