实时三维超声心动图测量室壁瘤左心室功能的临床应用

Clinical application of real-time three-dimensional echocardiography for aneurysmal left ventricular function

目的探讨实时三维超声心动图(RT-3DE)检测室壁瘤左心室功能的可行性与准确性。方法分别应用实时三维超声心动图和二维超声心动图测量了12个有室壁瘤的心脏,使用实时三维全容积成像勾画左心室心内膜面,结合实时三维测量分析软件,分别采用二﹑四﹑八平面法测量左心室功能;将三维测量的左心室功能与二维超声测量以及左心室造影测量结果相比较。结果实时三维超声心动图能显示室壁瘤左心室的整体形态;实时三维超声心动图测量的左心室射血分数(LVEF)与二维Simpson法及左心室造影测量的LVEF有较好的相关性(r=0.77,r=0.95,P<0.01);但采用二维方法测量的左心室容积小于三维方法;使用三维各平面法测量左心室容积时,二平面法与四、八平面法测值之间差异存在统计学意义(P<0.01),四平面法与八平面法测值之间差异则不存在统计学意义(P>0.05)。结论实时三维超声心动图能准确测量室壁瘤左心室容积,为评价左心室功能提供了新的工具。

Objective To evaluate the feasibility and accuracy of real-time three-dimensional echocardiography（RT-3DE） for aneurysmal left ventricular（LV） function. Metlmds A total of twelve anemysmal hearts was measured by RT-3DE and two-dimensional eehocardiography （2DE）. In RT-3DE ＂full volume＂ imaging, LV volume were outlined and calculated using 2,4,8-plane method with the analysis software of RT-3DE. The LV function was measured by Simpson＇s method with 2DE. The LV function by RT-3DE was compared to 2DE and left ventrieular angiography. Results The RT-3DE could show the whole shape of aneurysmal LV; There was moderate correlation between left ventricular ejection fraction（LVEF） measured by RT-3DE and 2DE（ r =0. 77, P 〈0. 01 ）. A significant correlation between LVEF measured by RT-3DE and LV angiography （r = 0. 95, P 〈 0.001 ）was observed;but LV volume with 2DE was smaller compared to those with other methods ;There were significant difference between LV volume in 2-plane and those in 4,8-plane（P 〈0. 01 ） ,but no significant difference was found between 4-plane and 8-plane（P 〉0.05）. Conclusion RT-3DE can accurately quantify aneurysmal LV volume, which could provide a new technique for evaluation of LV function.