实时三维超声心动图定量测定先天性心脏病右心室功能的探索性研究  

Exploration on Right Ventricular Volume and Ejection Fraction in Congenital Heart Disease by Real-time Three-dimensional Echocardiography

作　　者：覃诗耘[1] 郭盛兰[1] 陈敏华[2] 计慧敏[2] 邓燕[1] 吴棘[1] 黄莺[2] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁市530021 [2]广西医科大学

出　　处：《中国超声医学杂志》2009年第7期657-660,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西科学基金资助项目（No.桂科基0575061）

摘　　要：目的评价实时三维超声心动图（RT3DE）成像技术定量测定先天性心脏病（congenital heart diseases，CHD）患者右心室功能的可行性及有效性。 方法应用RT3DE技术对64例CHD患者及34例正常人定量测定其右心室（RV）舒张末期容积（EDV）、收缩末期容积（ESV）、每搏输出量（SV）及射血分数（EF），同时与二维超声心动图（2DE）测定的右室功能相比较。 结果（1）RT-3DE所测右心室容积及SV与2DE超声所测值相关性良好（r=0．815～0．970，P（0．01），且高于2DE所测值，差异有统计学意义（P〈0．05）；右心室射血分数2DE与RT-3DE之间无显著性差异（P=0．300）；（2）RT3DE所测的房间隔缺损（ASD）患者右室ESV、EDV及SV较正常对照组增大且有统计学差别（P〈0．05），右室EF较正常对照组降低且有统计学差异（P〈0．05）；（3）RT～3DE所测的室间隔缺损和／或动脉导管未闭（VSD／PDA）患者右室EDV与正常对照组之间无统计学差异（P）0．05），右室ESV较正常对照组增大，EF及SV则较正常对照组降低且均有统计学意义（P〈0．05）。 结论通过RT3DE成像技术及Qlab软件分析，可为CHD患者右心室容积的测量及发现心室功能的变化情况，提供一种方便、无创而有效的新方法，是对2DE测定心功能的有效的补充。Objective To evaluate the possibility and validity of real-time three dimensional echocardiography （RT-3DE） in the quantitative assessment of the right ventrieular volume and ejection fraction in patients with congenital heart disease. Methods Sixty four patients with congenital heart disease and thirty-four normal subjects were studied by using RT-3DE. We quantitatively assessed their right ventricular volume and ejection fraction, meanwhile, wehad compared the value measured by RT-3DE to two dimensional echocardiography （2DE） . Results （1） There was a good correlation between right ventricular volumes and SV obtained from 2DE and RT-3DE （r = 0. 903 - 0. 970,P〈0.01）. Right ventricular volumes calculated from 2DE were significantly lower than those obtained from RT-3DE （P〈0.05）, the difference has statistical significance, and the right ventricular ejection fraction was no significant difference between them （P〈0. 300） . （2） The right ventrieular volume and SV of patients with ASD were significantly higher than those obtained from normal subjects （P〈0.05）, which has statistical difference, and the right ventricular EF was significantly lower than that obtained from normal subjects （P〈0.05） . （3） RVEDV of patients with VSD/PDA was no significantly difference compared with that obtained from normal subjects （P〈0.05）, but RVESV was significantly higher. RVSV and RVEF was lower than them, which have statistical significance （P〈0.05） . Conclusions As a valid supplement to 2DE, right ventricular volumes and function in CHD patients could be quantitively assessed by RT 3DE and Qlab analysis software, which had provided a new reliable, uninvaded way to evaluate irregularity ventricular volumes and function, and would have great value in clinical practice in the future.

关 键 词：超声心动图描记术 实时三维 心室容积 射血分数 先天性心脏病 

分 类 号：R540.45[医药卫生—心血管疾病] R541.1[医药卫生—内科学]