实时三维超声心动图右心室容积-时间曲线评价正常人右心整体和局部心肌功能的临床研究  

Analysis of global and regional normal right ventricular function using volume-time curves by real-time three-dimensional echocardiography

作　　者：韩伟[1] 谢明星[1] 王新房[1] 吕清[1] 王静[1] 杨亚利[1] 路晶[1] 

机构地区：[1]华中科技大学同济医学院协和医院超声影像科 湖北省分子影像重点实验室,武汉430022

出　　处：《中华超声影像学杂志》2008年第2期97-99,共3页Chinese Journal of Ultrasonography

摘　　要：目的 用实时三维超声心动图右室容积-时间曲线评价正常人右室整体和局部收缩及舒张功能。方法 选取正常人65例，进行实时三维超声心动图全容积采集，将图像导入TomTec工作站，4DRV-function软件行图像处理，半自动勾画心内膜，通过半自动探测出右室轮廓线，构建右室三维模型，软件将右室划分成三个节段：流入道（inflow）、流出道（outflow）和体部（body）；获取右室整体和局部容积-时间曲线，记录右室整体及各节段舒张末容积（EDV）、收缩末容积（ESV）、射血分数（EF）、峰值排空率（PER）、峰值充盈率（PFR）等；同时观察各测量指标随年龄增加的变化规律。结果 ①正常人整体和局部右室容积-时间曲线均显示为“U”型曲线。各节段EF不同，右室流入道部最大，右室流出道部最小，差异具有统计学意义（P〈0．05）；各节段PER和PFR不同，流人道和体部较流出道大，差异具有统计学意义（P〈O．05）。②整体及局部EF和PER随年龄增加未见明显变化（r=-0．16～0．12，P〉0．05；r＝0.10～0.23，P〉0．05），而PFR随年龄增加呈下降趋势（r=-0.35～-0.56，P＜0.05）。结论 实时三维超声心动图右室容积-时间曲线可以准确、客观地评价右心整体和局部心肌收缩和舒张功能。右室流入道对右室舒缩功能贡献最大。临床评价右心舒张功能时，应充分考虑年龄因素的影响。Objective To evaluate the global and regional normal right ventricular（RV） function using volume-time curves（VTC） by real-time three-dimensional echocardiography（RT-3DE）. Methods Sixty-five normal volunteers were studied. All the three-dimensional echocardiographic datasets were acquired by Philips iE33 medical system. RV volume parameters were offline assessed by TomTec 4D RV- function software. The right ventricular global and regional VTC were provided by the system. End diastolic volume（EDV）, end systolic volume（ESV）, ejection fraction（EF）, peak filling rate （PFR）, and peak ejection rate（PER） from VTC were investigated. Results ①RT-3DE datasets with good endocardium imaging were acquired in 60 volunteers. Global and regional VTC of RV were ＇U-shaped＇ and uniform. ②The values of EF were significantly difference in three segments （ P 〈0.05）. The inflow showed the highest EF,outflow showed the lowest. The PER and PFR of inflow and body segments were larger than those of outflow significantly （ P〈0.05）.③PFR was significantly affected by increasing age （ r = - 0.35～ - 0.56, P〈 0.05） ,this result was mostly marked at the inflow and body segments. In contrast,EF and PER were stable with aging. Conclusions RV-VTC can evaluate RV function. Regional function of normal RV is heterogeneity,the RV inflow segment＇s contribution to the whole RV function is the largest among three segments. The age-related changes of RV myocardium should be fully taken into consideration when assessing RV diastolic function.

关 键 词：超声心动描记术 实时三维 心室功能 右 容积-时间曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学]