近端等速表面积法测量二尖瓣狭窄瓣口面积的研究

Calculation of mitral valve area in mitral stenosis using the proximal isovelocity surface area method

目的 探讨近端等速表面积法 (PISA)和近端球缺表面积法 (PSSA)测量二尖瓣狭窄 (MS)瓣口面积(MVA)的准确性。方法 2 0例接受瓣膜置换术及 3 0例非手术的MS患者 ,应用PISA、PSSA、二维超声心动图法 ( 2DE)及压差减半时间法 (PHT)法测量MVA。结果 ① 4种超声方法均与手术直接测值 (aMVA )高度相关 ;② 2DE法高估了aMVA ,PSSA、PHT、PISA法与aMVA无显著性差异。③PISA法高估了PSSA法 ,但无显著性差异。结论 PISA和PSSA测量MVA均有一定的准确性 ,但PISA法轻度高估MVA ,PSSA法具有更高的临床应用价值。

Objective To evaluate the accuracy of proximal isovelocity surface area method (PISA)、proximal segment surface area method (PSSA)、two dimensional echocardiography (2DE)、pressure half time method (PHT) in measuring the mitral valve area (MVA) in mitral stenosis.Methods MVA obtained with 4 ultrasonic methods were compared with the value obtained directly during operation (aMVA).Results ① All the 4 methods were highly correlated with aMVA,and the correlation coefficient of PISA was the lowest.② 2DE overestimated the aMVA and there was no significant difference between the other 3 methods and aMVA.③ PISA method overestimated the value of PSSA but the difference was not significant.Conclusions PISA and PSSA are relatively accurate in assessment of MVA in mitral stenosis,but PISA has a little overestimation.PSSA method is more convincing and applicable.