多平面经食管三维超声心动图测量左室心肌重量的实验研究  

Quantitative Assessment of Left Ventricular Mass by Multiplane Transesophageal Three-dimensional Echocardiography

作　　者：王旭[1] 张运[1] 张薇[1] 张梅[1] 林蔚青 郑昭伦[1] 钟明[1] 姚桂华[1] 解敏[1] 钟敬泉[1] 鹿庆华[1] 

机构地区：[1]山东医科大学附属医院心脏内科,北京科力公司250012

出　　处：《中国超声医学杂志》1997年第9期1-7,共7页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金

摘　　要：为了探索定量评价左室肥厚的新方法，本文采用多平面经食管超声心动图三维重建系统，测量了18只实验犬冠状动脉结扎前后的在体心脏左室心肌重量（LVM），并以LVM的解剖学测值为标准对照，与M-型超声Penn氏方法进行了比较。结果显示，冠状动脉结扎前，三维超声心动图（3DE）及Penn氏方法的LVM测值均与其实测值取得了高度相关（r分别为0.95，0.91，SEE分别为2.1g，3.6g），两种方法所测LVM与其实际值间均无显著性差异（P均＞0.1）;冠状动脉结扎后，Penn氏方法的测量结果与LVM实际值的相关性显著下降（r=0.63，SEE=7.9g），而3DE方法的测值仍与LVM的解剖学测值保持高度相关（r=0.96，SEE=2.2g）。表明：3DE可准确测量LVM，且不受左室几何形状的影响，因而在评价高血压合并冠心病患者心肌肥厚时，较之传统的M-型超声Penn氏方法具有显著的优越性。Left ventricular mass (LVM) is an important clinical variable. The aim of this study was to develop a multiplane transesophageal echocardiography three-dimensional reconstruction system in LVM determination and compare it with M-mode echocardiographic method. Epicardial M-mode and multiplane transesophageal echocardiography were performed in 18 open-chest dogs before and after coronary artery ligation and LVM was calculated by two methods: 1. Penn's formula based on M-mode images; 2. 3-DE method based on reconstruction of 18 cross-sectional images of the left ventricle, which were obtained by rotating the phased array of multiplane transesophageal echocardiography probe. These results were compared with the actual weight of LVM. The results showed that LVM estimated by 3DE correlated highly with the actual value of LVM both be fore and after coronary artery ligation (r = 0. 95, SEE = 2.1g: and r = 0. 96, SEE = 2. 2g,respectively); on the other hand. the correlation of LVM measured by Penn's convention correlated highly with the actual value be fore cornary artery ligation (r =0. 91, SEE = 3. 6g ), but differed significantly after coronary artery ligation (r = 0. 63, SEE = 7. 9g). It was concluded that 3-DE is able to quantitatively assess LVM with high accuracy both in normal hearts and in hearts with regional wall motion abnormalities. and there fore is superior to M-mode echocardiogaphy in measuring LVM in patients with combined hypertension and coronary artery disease.

关 键 词：左室 心肌重量 超声心动图 心室肥厚 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]