实时三维超声心动图测量左心室容积的实验研究

Experimental study on real-time three-dimensional echocardiography for quantifying left ventricular volume

目的 探讨实时三维超声心动图 (RT 3DE)检测体外模拟左心室室壁瘤条件下的左心室容积的可行性与准确性。方法 使用RT 3DE系统采集 1 5个模拟左心室室壁瘤的橡胶水囊 (对称性 7个 ,非对称性 8个 )以及 1 0只犬离体心脏 ( 6只有左心室室壁瘤形成 ,4只对照 )的“金字塔”形数据库 ,结合容积分析软件 ,分别用 2、4、8、1 6平面法勾画水囊及左心室内膜面 ,计算水囊与左心室容积。同时用二维超声Simpson法测量水囊与左心室容积 ;以注水法测量水囊及左心室实际容积作为参照 ,分别将不同平面法的RT 3DE容积测量值、2DE测值与之相比较。结果 在对称性橡胶水囊容积测量 ,RT 3DE各平面法与实际值均呈正相关 (r =0 .795～ 0 .994) ;2DE亦与实际值正相关 (r =0 .71 5 ) ;RT 3DE、2DE与实际值差异无显著性意义 (P >0 .0 5 )。在非对称性橡胶水囊容积测量 ,RT 3DE各平面法测量的左心室容积与实际值均呈正相关 (r =0 .775～ 0 .988) ,两者差异无显著性意义 (P >0 .0 5 ) ;2DE与实际值r =0 .5 92 ,两者差异有显著性意义 (P <0 .0 5 )。离体犬左心室室壁瘤组RT 3DE各平面法测量的左心室容积与实际值均呈正相关 (r =0 .765～ 0 .91 4) ,两者差异无显著性意义 (P >0 .0 5 ) ;2DE与实际值亦呈正相关 (r =0 .61 5 ) 。

Objective To evaluate the feasibility and accuracy of real-time three-dimensional echocardiography (RT-3DE) for quantifying aneurysmal left ventricular (LV) volume in vitro.Methods Fifteen aneurysmal rubber-bursas (7 symmetric,8 eccentric),10 excised canine hearts (6 with LV aneurysms and 4 without LV aneurysms) were measured by RT-3DE and two-dimensional echocardiography(2DE).In RT-3DE “full volume” imaging,rubber-bursas and LV volume were outlined and calculated using 2,4,8 and 16-plane method with the analysis software of RT-3DE.In 2DE the volumes were measured by Simpson′s method.The true LV volumes were measured by drained water,which served as a reference standard.The volume by RT-3DE and 2DE were compared to true volume.Results In symmetric rubber-bursas,RT-3DE correlated with actual volumes strongly ( r = 0.795 - 0.994 ) and there was good correlation between 2DE and true volume ( r = 0.715 ).There were no difference between RT-3DE,2DE and true volume ( P > 0.05 ).In eccentric rubber-bursas,RT-3DE correlated with actual volumes strongly ( r = 0.775 - 0.988 ) and weakly correlated between 2DE and true volume ( r = 0.592 ).There were no difference between RT-3DE and true volume ( P > 0.05 ) but difference between 2DE and true volume ( P < 0.05 ).In excised canine hearts,there was an excellent correlation between RT-3DE and true volume for aneurysms ( r = 0.765 - 0.914 ),while 2DE showed a lesser correlation ( r = 0.615 ).There were no difference between RT-3DE and true volume ( P > 0.05 ) but difference between 2DE and true volume ( P < 0.05 ).Conclusions RT-3DE can accurately quantify LV volume and provide a new tool to evaluate LV function.