实时三维超声成像技术测量右心室容积的方法学研究

Initial study of measurement methodology for right ventricular volume by real-time three-dimensional echocardiography

目的 评价实时三维超声心动图 (RT 3DE)技术测量右心室容积的可行性与准确性 ,并探讨最佳测量平面数。方法 使用RT 3DE系统采集 2 2例正常成人的右室“金字塔”形三维数据库 ,结合其容积分析软件 ,脱机采用心尖长轴多平面法 ,分别测量右室的舒张末期容积 (RVEDV)、收缩末期容积(RVESV) ,并由二者之差计算右室每搏量 (RVSV) ,同时在二维超声心动图上计算左室每搏量 (LVSV)。结果 RT 3DE上 2平面、4平面、8平面以及 1 6平面法测得的RVSV均与LVSV相关性好 (r分别为 0 .73 ,0 .69,0 .62 ,0 .66 ,P <0 .0 2 5～ 0 .0 0 2 5) ;2平面法测得的RVEDV较 4平面、8平面以及 1 6平面法测值差异有显著性意义 (P <0 .0 0 0 1 ) ;4平面法与 8平面法测值差异有显著性意义 (P <0 .0 5) ;8平面法与 1 6平面法测值间差异则无显著性意义 (P >0 .0 5)。结论 应用RT 3DE技术确定右室容积准确可靠、重复性高 ,提示临床上使用心尖

Objective To probe the feasibility and accuracy of using series apical long axis planes for the quantitative of right ventricular volumes with real-time three-dimensional echocardiography (RT-3DE). Methods Right ventricular 'Full volume' imaging was collec ted by RT-3DE system in 22 healthy volunteers. Right ventricular end-diastolic v olume (RVEDV) and right ventricular end-systolic volume (RVESV) was outlined by the volumetric analysis software of RT-3DE system offline using different apical multiple plane methods respectively. RVSV was calculated as the difference between RVEDV and RVESV, meanwhile LVSV was measured by two-dimensional echocardiography. Results There were good correlation between the RVSV measured from series planes methods and LVSV derived from two-dimensional echocardiography (r= 0.73 , 0.69 , 0.62 , 0.66 , separately); there were significant differences between the RV volume in biplane and those in four-plane, eight-plane and sixteen-plane (P< 0.000 1 ); there was difference between RV vol ume in four-plane and that in eight-plane (P< 0.05 ); but there was no difference between RV volume in eight-plane and that in sixteen-plane (P> 0.05 ).Conclusions RT-3DE could rapidly, accurately determine right ventricular volume. In view of right ventricle′s complex shape, the apical eig ht-plane measurement method is better for use in clinical.