二维及三维超声心动图对主动脉瓣环径测量的相关性研究

Correlation Between 2D and 3D Echocardiography in Measuring Aortic Annuals Diameter

目的探讨二维及三维超声心动图测量主动脉瓣环径(AAD)的相关性,以期为临床提供一种简单、准确的主动脉瓣环径计算方法。方法 52例因主动脉瓣狭窄行主动脉瓣置换术患者,常规经胸及经食管二维超声测量主动脉瓣环径,分别记为TTE-AAD、TEE-AAD;经食管三维超声(RT 3DTEE)采集主动脉根部全容积图像,利用QLAB定量软件获得主动脉瓣环相关参数:瓣环高度(H)、瓣环在投影平面内的面积(A2D)、投影平面中二维视图周长(C2D),并计算主动脉瓣环径(3D-AAD);将三维主动脉瓣环相关参数与二维超声测值进行对比和相关性分析。结果主动脉瓣环各参数收缩期及舒张期测值间差异均有统计学意义(P<0.05),其收缩期测值大于舒张期。TTE-AAD与TEE-AAD同一时相测值相比差异无统计学意义;二者与3D-AAD同一时相比较差异均有统计学意义(P<0.001),相对于3D-AAD,二维主动脉瓣环径测值偏小,但TEE-AAD和3D-AAD相关性较好(收缩期和舒张期r值分别为0.775和0.765)。通过直线回归分析,得出主动脉瓣环径的推演公式为3D-AADs=0.531×TEE-AADs+19.897(mm)。结论 RT 3DTEE及其定量分析软件可用于重建主动脉瓣环三维形态并计算瓣环相关参数,经食管二维超声测量的主动脉瓣环径与经食管三维超声计算的主动脉瓣环径相关性较好。

Objective To compare the results of 2D and 3D echocardiography in measuring aortic annulus diameter （AAD）. Methods Preoperitve transesophageal echocardiography （TEE）, transthoracic echocardiography （TTE） and 3D transesophageal echocardiography （RT 3D TEE）were performed on 52 patients who underwent aortic valve replacements to measure AAD. The parameters were compared between systole and diastole. Results The parameters in systole were significant greater than those in diastole （P〈0.05）. No significant differences in the AAD value were found between TTE and TEE. However, the AAD values determined with TTE and TEE were different from those determined with RT 3D TEE （P〈0.05）. The two-dimensional measurements produced smaller AAD values in both systole and diastole than the 3D measurements （P〈0. 001）. TEE correlated well with RT 3D TEE, with the r value of 0. 775 and 0. 765 for systole and diastole, respectively. The regression was 3D-AADs= 0. 531 X TEE-AADs＋ 19. 879 （mm）. Conclusion RT 3D TEE can accurately reconstruct the 3D structure of aortic annulus and calculate the aortic annulus dimension. TEE-AAD correlates well with 3D-AAD.