二尖瓣反流束的彩色三维超声重建

目的　探讨三维彩色多普勒超声在二尖瓣反流定量诊断方面的应用价值。方法　运用彩色三维多普勒超声对 3 1例二尖瓣反流患者进行反流束的三维重建 ,选择反流束最大时的图像 ,手动勾画反流束外边界。以VRML及Excel表格两种模式输出报告 ,分别显示所勾画的反流束形态及容积。结果　 3 1例患者中轻度反流 10例 ,反流束容积 <10ml ,皆为小火焰状。中度反流 11例 ,反流束容积 <3 0ml,皆呈火焰状或短棒状。重度反流 10例 ,反流束容积 >3 0ml,其中偏心型反流 7例 ,断面呈不规则半月形 ,反流束顶部常因血流折返而形成“分支”现象 ,其背面也可因反流束进入肺静脉而出现“出芽”现象 ;中央型反流 3例 ,呈棍棒状。结论　三维彩色多普勒超声提供了一个从空间立体的角度评价瓣膜反流的新方法 ,将超声对反流的定量提高到一个新的精确度。

Reconstruction of mitral regurgitant flow by 3D color Doppler imaging

Objective To evaluate the application of three dimensional(3D) color Doppler imaging in diagnosis and quantification of mitral regurgitation(MR).Methods In 31 patients whose echocardiography showed MR the regurgitant flows were reconstructed with 3D color Doppler imaging.Two reports were created in every flow: excel report displayed the largest regurgitant flow volume in cardiac circle and VRML report showed the 3D shape of the flow.Results In 10 patients with mild MR displayed by echocardiography the largest regurgitant flow volumes were less than 10 ml,which showed a little flame shape.Less than 30 ml in 11 patients with medium MR,which showed a flame or short club shape.In 10 patients with severe MR,7 of whom were eccentric regurgitant flows,the largest flow volumes were more than 30 ml,these 7 eccentric regurgitant flows showed irregular transverse sections and branched flow tops for the untreading blood flow,while the 3 others with central regurgitant flows showed club shape flows with or without branched tops.Conclusions 3D color Doppler imaging is a new method to evaluate valvular regurgitation in a three dimensional viewpoint and improve the accuracy of the quantification of regurgitant flow.