心脏超声造影评估恶性肿瘤化疗患者左心室射血分数与左心室容积的可重复性研究

Reproducibility of contrast-enhanced echocardiography for measurements of left ventricular ejection fraction and left ventricular volume in patients undergoing cancer chemotherapy

目的探讨心脏超声造影评估恶性肿瘤化疗患者左室射血分数（LVEF）与左室容积测量的可重复性。方法选取102例恶性肿瘤化疗患者，根据心脏超声图像质量分为图像清晰组（36例）和图像欠佳组（66例）。采集所有患者胸骨旁左室长轴、心尖四腔、心尖二腔、左心长轴切面以及三维动态图像，图像欠佳组的患者需进一步采集造影状态下胸骨旁左室长轴、心尖四腔、心尖二腔、左心长轴切面以及三维动态图像。两位相同资历的检查者分别应用EchoPac工作站获得所有患者不同测量方法的LVEF与左室容积测值。结果对于LVEF的测量，造影前图像欠佳组双平面Simpson法与三维全容积法测量的可重复性均较差（P〈0.01），但造影后图像欠佳组的测量可重复性有了明显提高（P〉0.05）。对于左室舒张末期容积的测量，造影前图像欠佳组中双平面Simpson法与三维全容积法测量的可重复性均较差（P〈0.01），但造影后测量的可重复性有了明显改善（P〉0.05）。对于左室收缩末期容积的测量，图像清晰组与图像欠佳组测量的可重复性均较好。结论心脏超声造影能明显改善图像欠佳的恶性肿瘤化疗患者LVEF与左室容积测量的可重复性。

ObjectiveTo assess the reproducibility of contrast-enhanced echocardiography and conventional echocardiography for measurements of left ventricular ejection fraction（LVEF） and left ventricular volume in patients undergoing cancer chemotherapy.MethodsOne hundred and two patients undergoing cancer chemotherapy were divided into satisfactory image group （36 subjects） and unsatisfactory image group （66 subjects） according to the quality of the recorded images. High frame rate two-dimensional and three-dimensional images were recorded from apical long-axis view, four-chamber view and two-chamber view of left ventricle. Contrast-enhanced echocardiography was performed in the unsatisfactory image group. Two equally experienced examiners measured the LVEF and left ventricular volume in all patients by EchoPac software.ResultsThe reproducibilities of Simpson′s biplane method and 3D full-volume echocardiography were low for measurements of LVEF in unsatisfactory image group （P〈0.01）. But they were improved significantly with contrast-enhanced echocardiography （P〉0.05）. The reproducibilities of Simpson′s biplane method and 3D full-volume echocardiography for measurements of left ventricular end-diastolic volume in unsatisfactory image group were also improved by performing contrast-enhanced echocardiography （P〉0.05）. The reproducibilities for measurements of left ventricular end-systolic volume were well in both group.ConclusionsThe reproducibilities for measurements of LVEF and left ventricular volume are improved in patients undergoing cancer chemotherapy with unsatisfactory images by using contrast-enhanced echocardiography.