实时三维超声测量右心室容积及收缩功能的可行性研究

目的分析实时三维超声心动图（RT-3DE）定量测量右心室容积和右心室射血分数（right ventricularejection fraction,RVEF）的可行性,及其与二维超声心动图（TDE）所测量的右心室容积、RVEF、右心室面积及右心室面积变化分数（right ventricular fractional area change,RVFAC）的相关性。方法通过实时三维超声心动图对85例行二尖瓣和（或）主动脉瓣置换术的风湿性心脏病患者采集其右心室全容积图像,同时用二维超声心动图测量右心室相关数值。将超声心动图图像导入Tomtec 4D Cardio View工作站,手动调节图像并描记心内膜边界后,软件分析自动得到右心室舒张末期容积（right ventricular end-diastolic volume,RVEDV）、右心室收缩末期容积（right ventricular end-systolic volume,RVESV）、RVEF;手动计算右心室搏出容量（right ventricular strokevolume,RVSV）。对实时三维超声心动图测值与二维超声测值进行相关分析。结果实时三维超声心动图测得的RVEDV、RVESV、RVSV较二维超声心动图测值大,差异有统计学意义（P〈0.05）;两者测得的RVEF比较,差异无统计学意义（P=0.51）。两种方法所测RVEDV、RVESV、RVSV及RVEF相关性良好（r=0.79、0.82、0.68、0.64,P〈0.05）;实时三维超声心动图所测RVEDV、RVESV与二维超声心动图所测右心室舒张末期面积、右心室收缩末期面积相关性良好（r=0.76、0.79,P〈0.05）。实时三维超声心动图所测RVEF与二维超声心动图所测RVFAC也有较好的相关性（r=0.56,P〈0.05）。结论实时三维超声心动图测量右心室容积、RVEF是可行的,与二维超声心动图测值间有良好的相关性;实时三维超声心动图能够更好的评价右心室收缩功能。

Feasibility of real time-three dimensional echocardiography for measuring volume and systolic function of right venticle

Objectives To evaluate the feasibility of real time-three dimensional echocardiography(RT-3DE) for measuring right ventricular volume and right ventricular ejection fraction(RVEF).Correlations of right ventricular volume,RVEF,right ventricular area and right ventricular fractional area change(RVFAC) measured by RT-3DE and two dimensional echocardiography were analyzed.Methods Eighty five patients with rheumatic heart disease who had undergone valvular replacement operation were enrolled in this study.Right ventricular volume and related values of right ventricle measured by RT-3DE,two dimensional echocardiography were imported to Tomtec 4D Cardio View software and manually adjusted.After endocardial boundary tracing,right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),RVEF were automatically calculated by software,and right ventricular stroke volume(RVSV) was manually calculated.Correlation analysis.in retative values of right ventricle measured with RT-3DE and two dimensional echocardiography were applied.Results RVEDV,RVESV,RVSV measured with RT-3DE were significantly higher than those measrued with two dimensional echocardiography(P<0.05);While there was no significant differences in RVEF(P>0.05).RVEDV,RVESV,RVSV and RVEF measured with RT-3DE and two dimensional echocardiography were positively correlated(r=0.79,0.82,0.68,0.64;P<0.05).RVEDV,RVESV,RVEF measured with RT-3DE were positively correlated(r=0.76,0.79,0.56;P<0.05) with right ventricular end-diastolic area,right ventricular end-systolic area and RVFAC measured with two dimensional echocardiography.Conclusions Right ventricular volume and RVEF measured with RT-3DE are feasible,which are positively correlated with those measured with two dimensional echocardiography.RT-3DE is better for evaluating the systolic function of right ventricle.