实时三维超声心动图测量右室容积的实验研究

目的利用实时三维超声心动图 (RT-3DE)检测体外右室模型和离体犬右室的容积,并与传统二维超声心动图(2DE)对照,探讨该技术的可行性与准确性. 方法使用RT-3DE系统采集12个不规则形状的模拟右室的橡胶水囊及10例离体犬心脏的右室"金字塔"型数据库,结合容积分析软件,分别用二、四、八、十六平面法勾画右室内膜面,计算右室容积;同时用二维超声的Simpson法测量右室容积;以注水法测量水囊及右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测值与实际容积相比较. 结果在橡胶水囊容积测量,RT-3DE各平面法测量的右室容积与实际值均呈正相关(r=0.765～0.912),两者无显著性差异(P>0.05);2DE值与实际值r=0.518,两者有显著性差异(P<0.05).RT-3DE各平面法之间相比较,八平面与十六平面法之间没有显著性差异(P>0.05),而它们与两平面、四平面法之间有差异(P<0.05).离体犬右室组RT-3DE各平面法测量的右室容积与实际值均呈正相关(r=0.728～0.906),两者无显著性差异(P>0.05); 2DE值与实际值亦呈正相关,r=0.502,两者有显著性差异(P<0.05).RT-3DE各平面法之间相比较,八平面与十六平面法之间没有显著性差异(P>0.05),而它们与两平面、四平面法之间有差异(P<0.05). 结论实时三维超声心动图能准确测量右室容积,为评价右室功能提供了新的有力的工具.对于右室RT-3DE测量,八平面法是准确与简便的最佳选择.

Validation of Real Time Three Dimensional Echocardiography for Quantifying Right Ventricular Volume: in vitro Study

Objective Compared to conventional two-dimensional echocardiography (2DE), we sought to test the accuracy of real-time three-dimensional echocardiography (RT-3DE) imaging system for evaluating RV volumes in vitro models and excised canine heart study. Methods Twelve eccentric rubber-bursas alike RV, 10 excised canine hearts underwent RT-3DE and conventional two-dimensional echocardiography (2DE). In RT-3DE "Full Volume" imaging, rubber-bursas and RV 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 method. The true RV volumes were measured by water displacement, which served as a reference standard. We compared RT-3DE?2DE with true volume. Results In eccentric rubber-bursas,RT-3DE correlated with actual volumes strongly ( r =0.765-0.912) and weakly correlated between 2DE and true volume ( r =0.518). There was no difference between RT-3DE and true volume ( P >0.05) but different between 2DE and true volume ( P <0.05). In different planes, there was no difference between 8-plane and 16-plane ( P >0.05) but different between 8-plane and 2,4-plane ( P <0.05). In excised canine hearts, there was an excellent correlation between RT-3DE and true volume ( r =0.728-0.906), while 2DE showed a lower correlation ( r =0.502). There was no difference between RT-3DE and true volume ( P >0.05) but different between 2DE and true volume ( P <0.05). In RT-3DE planes, no significant difference was found between 8-plane and 16-plane ( P >0.05) but significant difference existed between 8-plane and 2?4-plane ( P <0.05). Conclusion RT-3DE can accurately quantify RV volumes and provide a new tool to evaluate RV function. For RT-3DE in RV, 8-plane measurement method is the best choice for accuracy and convenience.