实时三维超声心动图测量二尖瓣环准确性的实验研究

目的 探讨应用实时三维超声心动图对二尖瓣环立体几何参数测量的方法 和准确性.方法 采用实时三维超声心动图对9只健康杂种犬心脏在活体状态下进行检查,获取三维全容积数据库,应用TomTec三维分析软件与MATLAB软件对二尖瓣环进行标识和测量.测量参数包括:①瓣环前外侧连合(anterior commissure,AC)与后内侧连合(posterior commissure,PC)间距离(commissure-commissure,CC);②通过瓣环前外侧连合与后内侧连合间连线中点并与之正交的室间隔侧和外侧瓣环间距离(septallateral,SL);③瓣环高度(height,H).二尖瓣环各参数的三维超声测值与离体心脏解剖测值进行比较.结果 ①CC,SL和H三维超声测值与离体心脏解剖测值的相关系数分别为r=0.83(P＜0.01),r=0.78(P＜0.05)和r=0.75(P＜0.05).②Bland-Altman分析示三维超声测值与离体心脏解剖测值一致性良好,CC,SL和H测值的均数差分别为0.22 cm,0.12 cm和-0.08 cm.结论 实时三维超声心动图能够较好地显示二尖瓣环立体形态,并能进行准确的空间几何测量,为二尖瓣环的定量研究提供了一种简便、可靠、无创的方法 .

Experimental investigation of the measurement accuracy of mitral annulus by real-time three-dimensional echocardiography

Objective To validate the accuracy of real-time three-dimensional echocardiography(RT3DE) in measuring spatial geometric parameters of mitral annulus.Methods Hearts in vivo of nine healthy hybrid canines were examined by RT 3DE.Three-dimensional full-volume images of mitral annuli were acquired.The annuli were annotated and measured by TomTec 4D MV-assessment software and MATLAB.The distance between anterolateral and posteromedial commissure (commissure-commissure, CC),septolateral distance (septal-lateral, SL) and height (H) of mitral annulus were measured.Parameters correlation coefficients of CC,SL and H derived by two methods were 0.83( P＜0.01),0.78( P＜0.05)well consistent with anatomic measurements, the mean differences of CC, SL and H between two methods were 0.22 cm,0.12 cm and-0.08 cm respectively.Conclusions RT-3DE is feasible in measuring mitral annulus, which provided a convenient, accurate and reliable new method for quantitative assessing annulus geometry configuration.