实时三维经食管超声Flexi Slice显像对心房颤动患者左心耳的定量测量

The role of Flexi Slice imaging by real time 3D transesophageal echocardiography in t of left atrial appendage in patients with atrial fibrillation

目的探讨实时三维经食管超声FlexiSlice显像技术定量测量心房颤动患者左心耳的价值。方法对46例心房颤动患者进行二维及实时三维经食管超声心动图检查，获取二维及FlexiSlice重建的0°、45°、90°、135°切面图像；获取FlexiSlice重建的左心耳短轴最大与最小开口径，并记录其切面角度，并与常规的多平面经食管超声取样测量进行比较。结果FlexiSlice在各重建切面的左心耳开口径测值与二维超声测值差异无统计学意义（P〉0．05）；FlexiSlice在深度测量中45。和90。切面与二维超声测值差异具有统计学意义（P值分别为0．045、0．002），0。和135。切面测值与二维超声差异无统计学意义（P〉O．05）。各二维图像测量值与FlexiSlice测量值具有较高的相关性。Bland—Altman分析显示94．29％数据点在一致性界限以内，其差值的一致性界限为（-2．5mm，2．9mm）；左心耳开口最大径分布在30。～160。之间，其中87％（40／46例）分布于90°～150°切面；最小径分布在0°～160°，其中85％（39／46例）分布在0°～60°切面。结论FlexiSlice显像可以较好地完成左心耳的测量，较传统二维食管超声具有明显的优势。

Objective To measure left atrial appendage （LAA） in patients with atrial fibrillation using Flexi Slice imaging by real time 3D transesophageal echocardiography（TEE）, and compare with common multiplane TEE. Methods Forty-six patients with atrial fibrillation were performed 2D and real time 3D TEE. Zero degree,45°,90° and 135° plane were acquired by 2D TEE and Flexi Slice remolding. Maximum and minimum values of ostium of left atrial appendage were acquired in the short axis view of LAA by Flexi Slice remolding. Results Compared with 2D TEE, values acquire by Flexi Slice in measurement of LAA ostium showed no significant difference（ P 〈0.05）. The depth measurement by Flexi Slicein 45° and 90° plane showed significant difference with 2D TEE（P-values were successively 0.045, 0.002） ,and in 0 and 135° plane showed no difference. All values measured by 2D TEE and Flexi Slices showed significant correlation. Bland-Airman plot showed that 94.29% of plots were among limits of agreement,whlch was （ -2.5 mm,2.9 mm）. The maximum values of LAA ostlum values ranged from 30° to 160°,among which 87% （40/46 cases） distributed between 90° and 150°, and minimum values ranged from 0° to 160°,among which 85% （39/46 cases） distributed between 0° and 60°. Conclusions Measurement of LAA can be well achieved by Flexi Slice imaging,which showed significant advantage compared with 2D TEE.