二维与实时三维经胸超声心动图评价二尖瓣脱垂  

Mitral Valve Prolapse with Real-time Three-dimensional Transthoracic Echocardiography:A Comparison with Two Dimensional Transthoracic Echocardiography

作　　者：陈昕[1] 冯伟[1] 杨亮[1] 曾燕玲[1] 韩玉娜[1] 杨军[1] 唐力[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳市110001

出　　处：《中国超声医学杂志》2012年第1期40-42,共3页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省自然科学基金项目(No.201102295)

摘　　要：目的探讨二维经胸超声心动图(2D TTE)与实时三维经胸超声心动图(RT3D TTE)评价二尖瓣脱垂(mitral valve prolapse,MVP)的准确性。方法采集42例MVP患者的2D TTE与RT3D TTE图像,明确瓣膜脱垂区域,与手术结果对照。结果 2D TTE与RT3D TTE评价MVP的准确度、敏感度、特异度分别为92.74%、91.95%、93.20%与96.58%、96.55%、96.60%。McNemar′s检验2种技术的准确度无显著差异。观察者间的一致性Kappa值分别为0.92、0.98(P<0.05)。RT3D TTE评价二尖瓣各区域脱垂的阳性释然比≥9.47,阴性释然比≤0.14。结论 2D TTE与RT3D TTE可以准确评价MVP,2种技术结合应用,为手术方案的制定提供可靠依据。Objective To evaluate the feasibility of two dimensional transthoracic echocardiography （2D TTE） and real-time three dimensional transthoracic echocardiography （RT3D TTE） for the assessment of mitral valve pro lapse （MVP）. Methods Forty two patients with MVP were performed by 2D TTE and RT3D TTE. The findings were compared with the surgical results. Results The accuracy, sensitivity and specificity for 2D TTE were 92.74%, 91.95% and 93.20% respectively. The same values for RT3D TTE were 96.58% ,96.55% and 96.60% respectively. There was no significant difference between the accuracy of them with McNemarrs test. Interobserver agreement for RT3D TTE （Kappa 0.92） was greater than that for 2D TTE （Kappa 0.98） （P〈0.05）. For RT3D TTE, the positive likelihood ratio was above or equal to 9.47 and negative likelihood ratio was below or equal to 0. 14. Conclusions 2D TTE and RT3D TTE are accurate for assessing MVP. It is important to combine 2D TTE with RT3D TTE for surgical plans.

关 键 词：经胸超声心动图 二尖瓣脱垂 实时三维 二维 KAPPA值 MVP 瓣膜脱垂 手术结果 

分 类 号：R540.45[医药卫生—心血管疾病] R542.51[医药卫生—内科学]