实时三维超声心动图评估正常成人右心室功能的准确性及重复性研究

Accuracy and reproducibility of real-time three-dimensional echocardiography in assessing right ventricular volume and systolic function

目的探讨实时三维超声心动图（RT-3DE）对右心室功能评估的准确性及重复性。方法选取2012年5月~2013年5月嘉兴市第二医院体检科心脏正常的成年健康志愿者48名为研究对象,在同一时期分别采用RT-3DE及心脏磁共振（MRI）检查右心室功能,以MRI的检查结果为参照,分析RT-3DE所测得的右室舒张末容积（（RVEDV）、收缩末容积（RVESV）和右室射血分数（RVEF）值的准确性及重复性。结果 48名参试者均完成检查项目,RT-3DE与MRI两种方法对RVEDV、RVEF的测定结果 [（RVEDV：（102.19±6.33）mL比（104.31±4.78）mL;RVEF：（51.59±4.88）mL比（52.38±4.86）mL）]比较,差异无统计学意义（t=1.792、0.833,P=0.080、0.409）;在RVED及RVEF的测定方面,RT-3DE与MRIV均呈正相关（r=0.90、0.89,P〈0.05）。RT-3DE与MRI对RVESV的测定结果[（53.09±3.37）mL比（49.79±5.79）mL]比较,差异有统计学意义（t=3.618,P=0.001）,即RT-3DE对RVESV的检测值相对较小,在RVESV的测定方面,RT-3DE与MRI呈正相关（r=0.72,P〈0.05）;两名分析者间及分析者自身评估差异比较均无统计学意义（P〉0.05）。结论 RT-3DE所测得RVEDV、RVEF与MRI相当,对RVESV的检测值相对较小,该方法简便、无创,且重复性好,准确性有待进一步提高。

Objective To evaluate the accuracy and reproducibility of real-time three-dimensional echocardiography （RT-3DE） in assessing right ventricular volume and systolic function. Methods 48 healthy adult volunteers from May 2012 to May 2013 in Department of Physical Examination of the Second Hospital of Jiaxing City were selected as study objects, and right ventricular function were measured by RT-3DE and cardiac magnetic resonance （MRI） at the same time respectively. The results of MRI being served as a reference, the accuracy and reproducibility of results of right ventricular end-diastolic volume （RVEDV）, right ventricular end-systolic volume （RVESV） and right ventricular ejec-tion fraction （RVEF） measured by RT-3DE were analyzed. Results 48 healthy adult volunteer participants completed the two kinds of examinations. There were no differences between the results of RVEDV and RVEF measured by RT-3DE and MRI [RVEDV： （102.19±6.33） mL vs （104.31±4.78） mL; RVEF： （51.59±4.88） mL vs （52.38±4.86） mL] （t=1.792, 0.833; P = 0.080, 0.409）; in the measurement of RVEDV and RVEF, there were positive correlation between RT-3DE and MRI （r=0.90, 0.89;P〈0.05）. The RVESV measured by RT-3DE and MRI had statistically significant difference [（53.09±3.37）mL vs （49.79±5.79）mL, t = 3.618, P= 0.001], the RVESV values measured by RT-3DE to was relatively small, in the measurement of RVESV, there was a positive correlation between RT-3DE and MRI （r =0.72, P〈0.05）. There was no significant differences between two analysts and themselves （P〉0.05）. Conclusion The results of RVEDV and RVEF measured by RT-3DE and MRI are equal and the value of RVESV is relatively smaller. RT-3DE is convenient, noninvasive and of good repeatability, but the accuracy should be further improved.