运用二尖瓣开放面积测量软件探讨二尖瓣反流的病因机制  

Mechanism of mitral valve regurgitation with mitral valve measurement software

作　　者：姚莉萍[1] 孙锟[1] 朱磊[2] 杨新[2] 席丽丽[1] 

机构地区：[1]上海交通大学医学院附属上海新华医院超声中心,上海200092 [2]上海交通大学图像处理与模式识别研究所

出　　处：《中华医学超声杂志（电子版）》2011年第2期23-26,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：上海市科研计划项目课题资助(09JC1410500)

摘　　要：目的本研究在实时三维超声心动图基础上,运用自主研制的二尖瓣开放面积测量软件分析二尖瓣瓣膜在正常和病理状态下的开放规律,并进行量化评估,旨在探讨二尖瓣关闭不全的病因机制。方法 2005年5月至2007年12月上海儿童医学中心心脏中心收治的29例二尖瓣中度反流儿童作为病变组,另选取正常儿童28例作为对照组。运用Philips Sonos7500型超声诊断仪和配置的实时三维超声探头,探头频率2～4MHz。将获取的全容积图像导入自主研发的PC工作站,在Matlab7.0.0.19920(R14)平台上将Dicom图像格式转换为bmp图像格式。通过自主研发的二尖瓣瓣膜开放面积测量软件VolEdit.exe1.0.0.1,采用人机交互模式逐帧测量一个心动周期中每一个时间点的瓣膜开放面积,记录测量结果。最后在Matlab7.0.0.19920(R14)平台上,将二尖瓣瓣膜开放面积数值输入,自动生成一个心动周期中二尖瓣瓣膜开放面积曲线图。计算机自动计算并保存以下参数的数值:瓣膜开放斜率最大的点(G点)、G点至峰值的时间间期(Int1)、峰值至瓣膜关闭的时间间期(Int2)、瓣膜开放间期(Int3)、瓣膜开放最大斜率(α),其中Int3=Int1+Int2。运用SPSS10.0软件进行统计学分析。结果病变组的G点至峰值的时间间期、瓣膜开放间期和瓣膜开放最大斜率与对照组比较差异有统计学意义;具体表现为:瓣膜开放持续时间延长[(0.631±0.167)个心动周期,(0.573±0.087)个心动周期,P<0.05];瓣膜开放至最大面积所需时间延长[(0.166±0.109)个心动周期,(0.079±0.062)个心动周期,P<0.05];瓣膜开放最大斜率降低[(7.15±2.72),(13.20±4.57),P<0.05]。病变组的瓣膜开放斜率最大点和瓣膜开放最大面积及瓣膜关闭的时间间期与对照组间比较差异无统计学意义。结论二尖瓣反流患儿二尖瓣瓣膜的异常运动与左心室心腔扩大、瓣下乳头肌相对位置改变以及张力装置对瓣膜牵拉力度和角�Objective Based on the real-time three-dimensional echocardiography,the opening mechanism of the normal mitral valve and the pathologic valve using the independently designed tritus software were analyzed to investigate the mechanism of mitral valve regurgitation. Methods In consecutive twenty-nine patients （including 12 males and 17 females,mean age：5.1±4.5） with moderate mitral regurgitation and twenty-eight healthy subjects （including 12 males and 16 females,mean age：5.3±4.4） were performed by real-time 3-dimensional echocardiogaphy. All images were imported offline into Matlab 7.0.0.19920（R14） and transformed from Dicom form to Bmp form. The opening valve area with man-machine reciprocation form in one cardiac cycle was measured by VolEdit.exe1.0.0.1. The area curve was generated in each case. The following parameters were calculated and conserved by computer automatically：（1） the time of inflection point（G point）：the point with the largest slope rate. （2） Int1：the interval from G point to peak value.（3）Int2：the interval from peak value to valve closure.（4）Int3：the interval of valve opening Int3= Int1＋Int2.（5）α value：the largest slope rate of the valve opening. Statistical analysis was performed by SPSS10.0. Results Significant difference was found between the two groups by Int1、Int3 time and α value（P0.05）. The duration of valve opening in abnormal valve was longer than that in normal valve（0.631±0.167,0.573±0.087,P0.05）. The interval between opening and the largest area in abnormal valve was longer than in normal valve（0.166±0.11,0.08±0.06,P0.05）. No significant difference of G point and Int2 time was found between the two groups（P0.05）. Conclusions The abnormal motion of mitral valve in the setting of mitral regurgitation is related to the enlargement of left ventricle and the altered balance of tethering and coapting forces on leaflets resulted from malposition of papillary muscle,which are important causes of mitral regurgita

关 键 词：超声心动描记术 二尖瓣 测量软件 

分 类 号：R725.4[医药卫生—儿科]