四维自动左室定量分析技术评价正常人左室容积及功能的初步研究

Clinical study on left ventricular volume and ejection fraction in normal subject by 4-Dimensional auto left ventrcular quantification

目的:探讨四维自动左室定量分析技术(4D AUTO LVQ)评价正常人左心室容积及功能的可行性及重复性。方法:在单心动周期(SB,single heart beat)及多心动周期(MB,multi-heartbeat)成像模式下分别采集20例正常志愿者左室三维图像(3-dimensional echocardiography),并分别使用4DAUTO LVQ技术测量左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)及射血分数(EF),同时使用二维双平面Simpson's法及M型Teich-holtz法检测同一组志愿者LVEDV、LVESV和EF。将4种方法所得的测值分别进行比较。结果:①M型测量的LVEDV测值与其他3种方法测值间差异有统计学意义(P<0.05),SB模式及MB模式下4D ATUO LVQ测量的LVEDV相关系数r为0.769;②SB、MB模式下4D ATUO LVQ方法测量的LVESV、双平面Simpson's法测量的LVESV测值与M型测值间差异均有统计学意义(P<0.05),SB与MB模式下测量的LVESV相关系数r为0.86;③SB、MB模式下测量的EF值与双平面Simpson's法及M型测值间差异均有统计学意义(P<0.05),SB与MB模式下测量的EF值相关系数r为0.428;Bland-Altman一致性分析表明4D AUTO LVQ在SB与MB模式下所测容积及EF值具有较高一致性。④SB模式下的3DE图像存储时间短于MB模式图像存储时间,差异有统计学意义(P<0.05);4D AUTO LVQ及Simpson's法后处理时间差异均无统计学意义(P>0.05)。⑤SB与MB模式下4D AUTO LVQ测量LVEF观察者内变异系数分别为8.50%、6.50%,观察者间变异系数分别为7.75%、6.50%。结论:4D AUTO LVQ技术定量分析左室容积及EF有效、可行、快捷,具有临床应用价值。

Objective：To initial explore the clinical feasibility,accuracy and reproducibility of evaluation of left ventricular（LV） volume and ejection fraction（EF） by 4-Dimensional Auto Left Ventrcular Quantification（4D AUTO LVQ） in three-dimensional echocardiography.Method：Single heartbeat（SB） and multi-heartbeat（MB） mode three-dimensional echocardiography（3DE） examinations were performed in 20 volunteers,Left Ventricular end-diastolic volume（LVEDV）,end-systolic volume（LVESV）,and EF were measured by 4D AUTO LVQ.Meanwhile,LV volume and EF were also calculated by 2DE Simpson＇s method and M-modeTeichholtz method.The measurement value of LV volume and EF by 4D AUTO LVQ in SB and MB mode was separately compared with every measurement value by other methods.Result：①The values of LVEDV were statistically significant between M-mode method and other three methods（P0.05）.LVEDV measured by 4D AUTO LVQ in SB mode correlated and agreed well with MB mode（r=0.769）.②There were significant difference in LVESV between M-mode method and other three methods.The correlation and agreement between SB and MB was well（r=0.86）.③Significant difference was found between 3DE and 2DE for EF,and also between 3DE and M-mode.Correlation between SB and MB3DE was poor（r=0.428）,but the agreement was good.④There were no statistically significant difference between average store time of the 4D AUTO LVQ and 2DE Simpson＇s method.⑤Intra-observer variability of SB and MB 3DE for EF measured by 4D AUTO LVQ was 8.50% and 6.50%,and the inter-observer variability was 7.75% and 6.50%.Conclusion：4D AUTO LVQ in three-dimensional echocardiography gives accurate,rapid and reproducible measurements of LV volumes and EF.