多平面经食管三维超声心动图测量左心室心肌重量  

Transesophageal Three dimensional Echocardiography Measuring Left Ventricular Mass

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] 鹿庆华[1] 朱式娟[1] 

机构地区：[1]山东医科大学附属医院心脏内科

出　　处：《中华超声影像学杂志》1998年第5期307-309,共3页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金

摘　　要：为了探索准确评价左室肥厚的超声心动图方法，利用自行研制的多平面经食管超声心动图三维重建系统（３－ＤＥ），测量了１８只实验犬冠状动脉结扎前后的在体左室心肌重量（ＬＶＭ），并以左室心肌重量的解剖学测值为标准对照，与二维超声心动图面积－长度法（２－ＤＥ）进行了比较。结果显示，冠状动脉结扎前，３－ＤＥ及２－ＤＥ测量的ＬＶＭ均与其解剖学测值高度相关（ｒ分别为０．９５，０．９０，ＳＥＥ分别为２．１ｇ，５．３ｇ）；冠状动脉结扎后，３－ＤＥ的测量结果仍与ＬＶＭ的解剖学测值保持高度相关（ｒ＝０．９６，ＳＥＥ＝２．２ｇ），而２－ＤＥ测值与实际重量的相关性则显著下降（ｒ＝０．７８，ＳＥＥ＝１０．７ｇ）。认为三维超声心动图能较二维超声心动图更为准确地测量左室心肌重量，尤其在节段性室壁运动不良造成左室严重变形的情况下优越性更为显著。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 two dimensional echocardiographic (2DE) method. Epicardial 2DE 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.Area length formula based on 2DE images. 2.3DE method based on reconstruction of 18 cross sectional images of left ventricle, which were obtained by rotating the phased array of multiplane transesophageal echocardiographic probe, into three dimensional format. These results were compared with the actual weight of LVM measured by anatomic method. The result showed that LVM estimated by 3DE correlated highly with the actual value of LVM both before and after coronary artery ligation (r=0.95, 0.96 respectively); on the other hand, the correlation of LVM measured by 2DE correlated highly with the actual weight before coronary artery ligation (r=0.90, SEE=5.3 g), but differed significantly after coronary artery ligation (r=0.78, SEE=10.7 g). We concluded that 3DE can quantitatively assess LVM with high accuracy both in normal hearts and in hearts with regional wall motion abnormalities, and therefore is superior to 2DE in measuring LVM in patients with coronary artery disease.

关 键 词：超声心动描记术 左室心肌重量 心肌梗塞 

分 类 号：R542.22[医药卫生—心血管疾病]