常规与对比增强实时三维超声心动图评价右心室容积-功能的准确性和可重复性研究  

Contrast-enhanced versus Routine Real-time Three-dimensional Echocardiography for Assessment of Right Ventricular Volume and Ejection Fraction: Accuracy and Reproducibility Validated by Magnetic Resonance Imaging

作　　者：叶文彬[1] 李金国[1] 孙斌[2] 江琼[1] 陈智勇[2] 段青[1] 陈良龙[1] 

机构地区：[1]福建医科大学附属协和医院心内科福建省冠心病研究所,福州市350001 [2]福建医科大学附属协和医院影像科,福州市350001

出　　处：《中国超声医学杂志》2010年第9期795-799,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的评价对比-增强(cRT3DE)和常规(rRT3DE)实时三维超声心动图在评估右室舒张末(RVEDV)及收缩末容积(RVESV)和射血分数(RVEF)的准确性和可重复性。方法 35例健康志愿者中符合入选要求者30例,在24 h内进行rRT3DE、声诺维cRT3DE和心脏电影磁共振成像(cM-RI)。分别采用Tom-Tec 4D RV-Function cAP软件对RT3DE及Argus软件对cMRI图像进行脱机分析,获得右室容积及功能测值。结果与rRT3DE比较,cRT3DE右室图像质量指数显著增加(3.2±0.7对2.5±0.8,P<0.001)。与cMRI比较,rRT3DE高估RVESV、低估RVEDV及RVEF(P均0<0.05);而cRT3DE仅有高估RVESV、低估RVEDV及RVEF的趋势,但差异无统计学意义。较之rRTSDE,cRT3DE右室容积及功能测值与cMRI的相关性更强(RVEDV,r=0.95对0.85;RVESV,r=0.95对0.81;RVEF,r=0.91对0.81)。Bland-Altman分析显示,较之rRT3DE,cRT3DE和cMRI右室容积及功能测值一致性界限更窄,cRT3DE测值在观察者间及观察者内的变异更小。结论声诺维对比增强造影显著改善实时三维超声心动图评价右心室容积和射血分数的准确性及可重复性。Objective To evaluate contrast agent-enhanced （cRT3DE） versus routine （rRT3DE） real-time threedimensional echocardiography for the assessment of the right ventricular volume and function. Methods Thirty healthy volunteers were examined by cardiac magnetic resonance imaging （cMRI）, cRT3DE and rRT3DE. Right ventricular end-diastolic, end systolic volume （RVEDV and RVESV） and ejection fraction （RVEF） were calculated offline respec tively by Argus software for cMRI and Tom-Tec 4D RV-function CAP software for RT3DE. Results Image quality in dex were improved significantly （3.2 ± 0.7 for cRT3DE vs. 2.5 ± 0.8 for rRT3DE, P〈 0. 001）. Compared to cMRI, rRT3DE overestimated RVESV and underestimated RVEDV and RVEF （P〈0.05, each）. The measurements by cRT3DE had better correlations than those by rRT3DE （r=0.95 vs. 0.85 for RVEDV,r=0.95 vs. 0.81 for RVESV, r=0.91 vs. 0.81 for RVEF）. Bland-Airman analysis showed that each measurement by cRT3DE had a smaller limit of the agreement with less inter- and intra-observer variabilities. Conclusions By injecting SonoVue, cRT3DE enhances the accuracy and the reproducibility for the evaluation of right ventricular volume and function.

关 键 词：右心室功能 实时三维超声心动图 磁共振成像 对比增强剂 声诺维 

分 类 号：R540.45[医药卫生—心血管疾病]