实时三维超声心动图与磁共振成像评价右心功能的对照研究

A comparative study of three-dimensional real-time echocardiography and MRI in the assessment of right ventricular cardiac function

目的:以磁共振电影成像法为对照,应用实时三维超声心动图定量评价右心室功能,探讨两项技术心功能评价指标的相关性及实时三维超声心动图在右心功能评价中的应用价值。方法:30例健康成年志愿者(男16例、女14例,年龄(49±3.2)岁),全部志愿者均于24 h内行心脏实时三维超声心动图和MRI检查。行实时三维超声心动图全容积显像方式采集图像数据,并导入TomTec工作站,应用4D RV-function软件行图像后处理,构建右室三维模型并进行心功能测量。最终获取舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)及射血分数(EF)等心功能参数。与MR多次屏气电影法测得右心室功能指标进行Pearson相关分析,并采用Bland-Altman法评价两种检查方法结果的一致性。结果:实时三维超声心动图测得的心功能指标平均EDV(143.5±23.2)mL,平均ESV(68.4±19.2)mL,SV(78.1±11.7)mL,EF(51.2±5.6)%,与MR多次屏气电影法测得的心功能指标EDV(147.5±26.8)mL(r=0.947),ESV(63.2±15.9)mL(r=0.909),SV(78.8±15.0)mL(r=0.788),EF(55.2±7.7)%(r=0.627)均无显著性差异,显示出较高相关性。结论:本研究显示实时三维超声心动图与1.5T磁共振成像评价右心功能各指标之间相关性高,在右心功能定量评价方面准确、可靠。

Objective： To investigate the value of three-dimensional real-time echocardiography in the assessment of right ventricular global function,in comparison with MRI.Methods： Thirty healthy volunteers（16 male,14 female,average age 49± 3.2 years old） underwent three-dimensional echocardiography and breath-hold MRI.Using iE33 medical Philips system,the end-diastolic volume（EDV）,end-systolic volume（ESV）,stroke volume（SV） and ejection fraction（EF） were determined by TomTec 4D RV-analysis software.The results from echocardiography were compared with those from MRI using Pearson correlation test and Bland-Altman-plot.Results： Mean EDV（（143.5±23.2） mL）,ESV（（68.4±19.2） mL）,SV（（78.1±11.7） mL） and EF（（51.2±5.6）%） determined by echocardiography correlated well with those by MRI（（147.5 ±26.8） mL（r=0.947）,（63.2±15.9） mL（r=0.909）,（78.8± 15.0） mL（r=0.788）,（55.2±7.7）%（r=0.627）.A strong correlation between three-dimensional real-time echocardiography and MRI was also found in Bland-Altman-plot.Conclusion： Three-dimensional real-time echocardiography can assess right ventricular global function accurately.It is a valuable method for evaluating cardiac function.