不同短轴切面的面积变化分数的研究

胸骨旁左室短轴乳头肌水平切面的面积变化分数与射血分数呈高度相关,但对其他切面的面积变化分数却少有研究。对25例心功能正常者,选择二维超声心动图各左室短轴切面,应用手动描迹球法与声学定量技术分别计算各相应切面的面积变化分数。结果:手动描迹球法及声学定量技术测得各短轴切面的面积变化分数均呈高度相关(r=0.88～0.96);各切面面积变化分数测值无显著差异(P>0.05)。结论:声学定量技术与手动描迹球法测量的面积变化分数相关良好;左室收缩功能正常者不同左室短轴切面的面积变化分数相同。     

二维超声对术前法乐氏四联症左室容量及收缩功能的评价

运用二维超声心动图和左室Ｘ线造影方法，评价９０例法乐氏四联症的左室容量和左室时血分数，各测值与年龄相匹配的４０例正常人对照。研究结果表明，二维超声心动图的Ｓｉｍｐｏｎ’ｓ和面积长度法的左室容量测值与左室Ｘ线造影面积长度法相应测值比较，它们之间呈高度相关，但二维超声的面积长度法测值较低于左室造影测值，法乐氏四联症患者的左室容量明显低于正常对照组，而左室射血分数与正常组对照无明显差异。结论，二维超声定量评价法乐氏四联症患者的左室容量时．以Ｓｉｍｐｓｏｎ’ｓ法更准确，面积长度法则轻度低估，术前法乐氏四联症患者的左室射血分数正常。     

速度向量成像技术评价扩张型心肌病室壁局部收缩功能

目的利用速度向量成像（WI）技术评价扩张型心肌病人（DCM）短轴切面圆周方向上心肌收缩功能。方法15例DCM病人与15例正常对照组，胸骨旁左室短轴切面乳头肌水平在VVI条件下录制左室短轴二维超声心动图，脱机VVI软件分析各节段圆周方向上收缩期峰值速度（Vs）、峰值应变（ε）及峰值应变率（SRs）曲线及左室收缩后剩余面积。结果DCM各节段短轴圆周方向上Vs、ε、SRs明显低于对照组相应节段，收缩后左室剩余面积明显大于正常对照组，均有显著统计学意义。结论VVI技术可客观地反映DCM的收缩功能状态，有望成为新的无角度依赖性的无创评价局部心功能的超声新方法。     

数字化二维超声心动图对健康人和心肌梗塞患者左室局部收缩功能定量研究

局部室壁运动异常(RWMA)是冠心病心肌缺血和/或梗塞的特征性改变,因此,对左室局部收缩功能定量分析具有重要意义。近年来,随着二维超声心动图(2DE)和数字化计算机图象分析技术发展,对左室局部功能研究也从定性阶段进入定量阶段。本文利用2DE和数字化计算机图象分析辅助系统对50例健康人和45例心肌梗塞(MI)患者左室局部收缩功能进行了定量分析。左室局部收缩功能分别用短轴切面     

心内膜自动检测技术测量左室腔面积可靠性的研究

对３０例正常人进行了二维超声心动图检查，分别用手工描绘和心内膜自动检测技术测量左室乳头肌短轴观和心尖四胜观的左室腔面积。结果显示：两种方法测量的乳头肌短轴观的左室舒张末期面积（ＥＤＡｓ）、收缩末期面积（ＥＳＡｓ）、面积变化分数（ＦＡＣｓ）均高度相关（ｒ分别为０．８６，０．８０，Ｏ．７９）；心尖四腔观的左室舒张末期面积（ＥＤＡａ）、收缩末期面积（ＥＳＡａ）、面积变化分数（ＦＡＣａ）亦均高度相关（ｒ分别为０．８０，０．８６，０．９０），表明利用心内膜自动检测技术能够检测、识别心内膜轮廓，测量左室腔的面积，这为无创性评价左室功能提供了一个新方法。     

不同切面二维超声心动图对成人主肺动脉内径测量的应用价值

目的：对比分析经胸二维超声心动图（transthoracic echocardiography,TTE）不同切面在成人主肺动脉（main pulmonary artery,MPA）内径测量中的准确性,并探讨不同切面测量的检测价值及临床应用。方法：连续对194例成人行经胸二维超声心动图检查,于不同切面测量主肺动脉内径,全部纳入研究者均在我院行胸部CT检查,并测量MPA,采用LSD-t检验分析经胸二维超声心动图不同切面MPA测量值之间、超声心动图与胸部CT测量值之间是否存在统计学差异。结果：经胸二维超声心动图不同切面MPA测量值之间存在差异（P <0.05）,剑突下切面测得的MPA内径较胸骨旁切面偏小（P <0.05）。胸骨旁大动脉短轴切面、剑突下肺动脉长轴切面、剑突下大动脉短轴切面与胸部CT主肺动脉测量值之间存在差异（P <0.05）,以上三个切面MPA测量值较胸部CT偏小。胸骨旁右室流出道长轴切面与胸部CT主肺动脉内径测量值之间差异无统计学意义（P> 0.05）。经胸二维超声心动图不同切面测得的MPA与胸部CT测量值之间呈显著正相关（r=0.859、0.889、...     

声学定量技术评价左室舒张功能的价值

声学定量技术评价左室舒张功能的价值山东医科大学附属医院心内科张梅，张运，姚桂华，范觉新，赵玉霞为了探讨左室容量与左室舒张功能的关系，本研究对３０例正常人进行了二维超声和脉冲波多普勒超声心动图检查，其中男１８例，女１２例，年龄１８～４２岁，平均２３．３...     

双平面经食管超声心动图自动边缘检测评价左室腔面积的研究

通过１０例行自动边缘检测检查患者的６０对数据，与手动描记结果的对照研究表明，经食管超声心动图自动边缘检测技术测定的左室舒张末期面积、收缩末期面积和面积变化分数均与手动描记的结果高度相关。证明该技术能够可靠地用于临床心血管患者的心功能检测和药物疗效的评价。     

实时三维超声诊断双腔右心室的价值

探讨实时三维超声心动图技术诊断双腔右心室的价值。方法 以手术结果为金标准，对20例双腔右心室(DCRV)患儿运用二维和实时三维超声心动图进行剖析诊断，两种方法诊断结果与手术结果进行比较。结果 大动脉短轴立体切面和心尖四腔立体切面经剖析后能对双腔右心室的各种畸形进行准确诊断。以手术结果为金标准，实时三维超声心动图诊断正确率为100%，二维超声心动图诊断诊断正确率为90%，但两种方法没有统计学差异（P>0.05）。结论 大动脉短轴立体切面联合心尖四腔立体切面，可更直观的剖析结构畸形，提高双腔右心室诊断准确性,推荐实时三维超声心动图作为DCRV诊断的常规检测方法。     

左室短轴切面周径缩短分数评估左室收缩功能的研究

采用二维超声心动图左室短轴切面周径缩短分数(△CD)评估左室收缩功能,研究显示,△CD计算简单、操作方便可作为评估左室收缩功能的一个参数。     

Echocardiographic assessment of systolic and diastolic left ventricular function using an automatic boundary detection system

Systolic and diastolic left ventricular function was assessed using an echocardiographic automatic boundary detection system (ABD) in 50 unselected patients undergoing left cardiac catheterisation. Automatic boundary detection system derived parameters (fractional area change [FAC], peak positive rate of area change [+dA/dt] and peak negative rate of area change [?dA/dt]) were compared with invasively (left ventricular angiography and pressures) and non invasively (Doppler mitral filling velocities and isovolumic relaxation time) acquired conventional indices of ventricular function. Adequate detection of endocardial boundaries and subsequent measurements using the ABD system were achieved in 40/50 (80%) patients in the short axis parasternal view, in 41/50 (82%) in the apical four chamber view and in 34/50 (68%) in both views. For the whole group of patients the FAC (maximal left ventricular diastolic area — minimal left ventricular systolic area/maximal left ventricular diastolic area) estimated in the short axis view correlated with the angiographic ejection fraction (EF) measured in the right oblique projection (r=0.51, p<0.001). There was only a weak correlation of the FAC estimated in the apical four chamber view with the EF (r= 0.36, p<0.01). The mean FAC (mean value of the FAC in the short axis and apical four chamber views) correlated reasonably with the EF (r=0.62, p<0.0001). There was no correlation between ABD derived parameters and left ventricular end diastolic pressure (LVEDP) in these patients. In a subgroup of patients with normal coronary arteries and left ventricular function (n = 17), although there was no correlation between EF and FAC, there was a strong positive correlation between FAC (apical four chamber and mean) and LVEDP (r=0.77, p<0.01 and r=0.87, p<0.01 respectively). No correlation was found in these patients between EF and LVEDP. In a further subgroup of patients with angiographically abnormal left ventricular function (EF<45%), there was a positive correlation between FAC (short axis, apical four chamber and mean) and EF (r=0.52, p<0.05, r=0.83, p<0.0001 and r=0.80, p<0.001 respectively) and a negative correlation between FAC (short axis and mean) and LVEDP (r=?0.52, p<0.05 and r=?0.60, p<0.01 respectively). There was also a negative correlation between LVEDP and EF in the same subgroup of patients (r=?0.65, p<0.01). None of the ABD derived parameters correlated with non invasively acquired indices of diastolic ventricular function (peak early left ventricular diastolic filling blood velocity [Emax], peak late diastolic velocity [Amax], E/A ratio and isovolumic relaxation time [IVRT], but there was a consistent positive correlation between ?dP/dt and + dA/dt estimated in the four chamber view (r=0.5, p<0.01, all patients). Therefore, although ABD derived parameters cannot be used in an interchangeable way with ejection fraction, they do provide a rapid, bedside method for the assessment of left ventricular function. FAC and dA/dt do appear to reflect left ventricular performance both in patients with normal ventricles and in patients with impaired left ventricular function.     

超声心动图自动边缘检测评价冠心病心绞痛患者左房左室功能

本文应用超声心动图自动边缘检测技术（ＡＱ）对冠心病心绞痛患者和正常组的左房左室功能进行分析。结果显示，所测冠心病心绞痛患者的左室面积变化分数（ＦＡＣ）、峰值充盈率（ＰＦＲ）均低于正常值，峰值充盈时间（ＴＰＦＲ）延长；左房舒张末期面积（ＥＤＡ）、收缩末期面积（ＥＳＡ）增大，面积变化分数（ＦＡＣ）、峰值排空率（ＰＥＲ）小于正常值，两组相比Ｐ均＜０．０５～０．０１。该法快速简便，能很好地反映冠心病心绞痛患者的左房左室功能。     

Dynamic on-line quantification of biventricular function with acoustic quantification (AQ)

Objectives. Acoustic quantification (AQ), a recently developed ultrasonic integrated backscatter imaging system providing on-line measurements of ventricular cavity areas and their functional indexes, was validated in comparison to angiography and Doppler derived systolic dP/dt. Normal AQ-reference values were established. Methods and Results. 1. In 45 patients undergoing heart catheterization, AQ derived areas in end-diastole (EDA), end-systole (ESA) and the resulting fractional area change (FAC) in apical 2- and 4-chamber view were compared to the corresponding biplane angiographic data. All correlations yielded significant values (p<0.0001; EDA: r=0.90, SEE=2.6 cm²; ESA: r=0.91, SEE=2.2 cm²; FAC: r=0.90, SEE = 4.1%). However, AQ-areas were underestimated by about 25%. 2. In 36 patients with mitral regurgitation AQ-FAC and AQ derived systolic dA/dt were compared to the Doppler derived systolic dP/dt, yielding significant correlations with r=0.91 and r=0.87; p<0.0001. 3. In 50 healthy subjects, AQ derived EDA, ESA and FAC averaged 25.7 ± 4.9, 14.7 ± 3.3 cm² and 43.2 ± 4.8% for the left, and 17.1 ± 3.8, 9.0 ± 2.9 cm² and 47.3 ± 9.2% for the right ventricle. For EDA normalized peak filling (PFR) and ejection rates (PER) yielded 2.7 ± 0.28 and -2.4 ± 0.42 EDA/sec for the left and 3.4 ± 0.74 and -2.9 ± 0.62 EDA/sec for the right ventricle. The interobserver and day-to-day variability of AQ in healthy subjects and cardiac patients was low for EDA, ESA and FAC (<12%) and higher for PFR and PER (<20%). Conclusion. In comparison to angiography AQ reliably quantitates on-line left ventricular fractional area change, although AQ- areas are underestimated. AQ offers reproducible values of systolic and diastolic function and a new approach to cardiac patients.     

声学定量技术测量正常人左心射血分数为何出现偏差──42名健康医学生声学定量法和超声心动图法左心功能测定的对比研究

用声学定量技术（ＡＱ）和超声心动图（ＵＣＧ）分别测定４２名健康医学生的左室舒张末期容积ＥＤＶ、收缩末期容积ＥＳＶ和射血分数ＥＦ。结果ＵＣＧ法测值与公认的正常值相符，两种方法的ＥＤｖ测值相近。而ＡＱ法的ＥＳＶ明显偏大，ＥＦ明显偏小。认为ＡＱ法对左室容积测值还是可信的。而ＡＱ法的ＥＳＶ偏大，导致ＥＦ值偏小。正常人左心ＥＳＶ和ＥＦ出现偏差的原因可能是正常心脏体积小，搏动强，因而固定了的心尖四腔切面收缩末期未能通过或接近左室的实际长轴，造成误差。相反体积扩大、搏动较弱的病态心脏，ＡＱ法通过心尖四腔观测量左心ＥＦ就比较准确。     

声学定量与SPECT平衡法心室造影检测右心功能的对比研究

应用单光子发射计算机断层显像（ＳＰＥＣＴ）平衡法心室造影和声学定量（ＡＱ）技术对７２名成年人进行右心功能检测。检测指标：右室射血分数（ＥＦ）或面积变化分数（ＦＡＣ）、峰值充盈率（ＰＦＲ）、峰值排空率（ＰＥＲ）、峰值充盈时间（ＴＰＦＲ）。结果：两种技术测得的相应参数值之间相关系数较低，且差异有显著性。提示用ＡＱ法检测右心功能的准确性欠佳。     

Comparison of methods of fractional area change for detection of regional left ventricular dysfunction

Three methods for assessment of fractional area change (FAC) and conventional versus cross-sectional segmentation were compared under conditions known to occur frequently during stress echocardiography. Quantitative analysis of 80 echocardiograms obtained from healthy subjects, patients with left ventricular (LV) dysfunction and after coronary artery bypass grafting included segmental and cross-sectional FACs by the centroid method with fixed and floating reference and a method with floating external reference. All segmental and cross-sectional FACs were equally sensitive to LV dysfunction, and segmental FACs failed to accurately predict the location of coronary lesions. The centroid method with floating reference and cross-sectional FACs were the least affected by surgery induced intrathoracic heart motion. In moderate to severe LV dysfunction FAC by the centroid method with floating reference and cross sections were rarely within normal limits. Cross-sectional FACs may prove to be useful in stress echocardiography. For viability studies segmental FAC by fixed reference appears to be the method of choice.     

Normal pulmonary artery and branch pulmonary artery sizes in children

To establish standards for pulmonary artery and branch pulmonary artery (PA and BPA) effective diameter (ED) and cross-sectional area (CSA) by using computed tomography (CT) data in children of a wide range of sizes and investigate the roundness of arteries. The ED (average of short and long axes) and CSA for the PA and BPA were measured using 1-mm collimation double-oblique reconstructions. Ordinary least squares regression was used to investigate models with various functional forms that related ED and CSA to patient size. Aspect ratio (AR), the short axis divided by long axis, was measured to evaluate roundness. The ideal diameter derived from CSA measurements was compared to ED, short axis, and long axis measurements. 108 CT examinations were analyzed in children without reason for abnormal PA size who ranged in age from 0 to 18 years (mean, 10.9 years; SD, 5.9 years). Interrater reliability was excellent. Data were modeled using a natural log-transformed response variable and a linear term for height as the independent variable. AR for the PA, right pulmonary artery, and left pulmonary artery measured <?0.9 for 38, 55, and 37%, respectively, indicating that many arteries are not round. Ideal diameter was not significantly different than ED but was for short- and long-axis diameter measurements. Normal ED and CSA for PA and BPA were determined for children of different sizes. Measurements outside of the normal range are consistent with dilatation or stenosis. Single diameter techniques are likely to introduce error.     

Left ventricular volumes assessed by different new three-dimensional echocardiographic methods and ordinary biplane technique

Three-dimensional (3D) echocardiography may overcome the problems with inadequate accuracy and reproducibility of 2D volume measurements of the left ventricle. Aims: To establish the in vitro accuracy and reproducibility of two new methods for 3D echocardiographic volume determination as compared to biplane measurements. Methods: Validation of volume measurements by a multiplane 3D method was performed on asymmetric latex phantoms (n=8, true volumes 45-304 ml) using rotational acquisition of 90 image planes. Porcine agarose-filled asymmetrical left ventricles (n=7, true volumes 34 – 280 ml) were measured by the same multiplane 3D method based on images acquired by probe rotation axis perpendicular (A) and parallel (B) to the ventricular long axis. Ventricular volumes were also obtained by a simplified 3D system using only the three standard apical views (C) and by the ordinary biplane Simpson’s method (D). Results: On latex phantoms systematic deviation from true volumes by multiplane 3D was less than 2%, and 95% variability of individual measurements from this mean was ± 4,9%. For accuracy on left ventricles, systematic bias was small with all the methods (<5%), but 95% variability of individual measurements was ±9,0%, 15.4%, 18.8% and 41.3% of true volumes for methods A-D respectively. Corresponding results in the same range were obtained for inter- and intraobserver variability. Conclusion: Individual in vitro volume estimates of left ventricles are of similar quality using apical multiplane or apical triplane 3D echocardiography. Both methods were superior to the ordinary apical biplane method, but inferior to multiplane 3D method with the probe directed perpendicular to the ventricular long axis.