实时三维超声心动图与磁共振成像对比评价室壁瘤患者左心室容积和功能的可行性和准确性  

Comparison of Real-Time Three-Dimensional Echocardiography With MRI for Assessing Left Ventricular Volume and Function in Patients With Left Ventricular Aneurysm

作　　者：陈立宇[1] 段福建[1] 张岩[1] 凤玮[1] 

机构地区：[1]中国医学科学院 北京协和医学院 心血管病研究所 阜外心血管病医院 心外科,北京市100037

出　　处：《中国循环杂志》2012年第2期133-136,共4页Chinese Circulation Journal

基　　金：中央级公益性科研院所基金(项目编号:2008F002)

摘　　要：目的:评价实时三维超声心动图(实时三维超声,RT-3DE)测量冠心病合并左心室室壁瘤患者左心室容积和功能的可行性和准确性。方法:根据室壁瘤大小分组,分别应用二维超声心动图(二维超声,2DE)、实时三维超声及磁共振成像(MRI)测量左心室室壁瘤患者手术前、后左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)、左心室射血分数(LVEF),以MRI结果为标准,进行对比研究。结果:①术前、术后二维超声和实时三维超声所测各值与MRI所测各值之间小室壁瘤组、中室壁瘤组差异均无统计学意义(P均>0.05)。②大室壁瘤组术前二维超声所测LVEDV、LVESV与MRI所测值之间差异均有统计学意义(P均<0.05),术前二维超声所测LVEF值与术后各值与MRI所测各值差异无统计学意义,术前、术后三维超声各值与MRI所测各值差异亦无统计学意义(P均>0.05)。③巨大室壁瘤组术前二维及三维超声所测LVEDV、LVESV较MRI所测值低,而LVEF较MRI所测值高,差异均有统计学意义(P均<0.05)。术后二维超声所测LVEDV、LVESV仍较MRI低,差异有统计学意义(P均<0.05)。术后实时三维超声所测各值与MRI所测各值之间差异无统计学意义(P均>0.05)。结论:与二维超声相比,实时三维超声测定大室壁瘤及巨大室壁瘤患者左心室容积与功能更接近MRI测量值,更准确可靠,但对于巨大室壁瘤患者所测术前左心室容积与MRI相比仍有低估。Objective： To evaluate the accuracy of real-time three-dimensional echocardiography（RT-3DE）for assessing left ventricular volume and function in coronary artery disease（CAD）patients with left ventricular aneurysm. Methods： A total of 116 CAD patients combined with left ventricular aneurysm were examined for their left ventricular end diastolic volume（LVEDV）,left ventricular end systolic volume（LVESV）and left ventricular ejection fraction（LVEF）before and after the operation with two-dimensional echocardiography（2DE）,RT-3DE and MRI respectively.The accuracy of 2DE and RT-3DE results were compared with MRI among different sized aneurysms. Results： ①In patients with small and medium size LV aneurysm,no real difference found between 2DE and RT-3DE with MRI for the above mentioned index,P0.05 respectively.②With large size LV aneurysm,LVDVE and LVDSE measured by 2DE before operation were different from MRI,P0.05 respectively.While pre-operative LVEF and other index after operation measured by 2DE weree no statistic differences from MRI;no differences between 3DE and MRI before and after the operation,P0.05 respectively.③With giant LV aneurysm,before the operation,the value of LVDVE and LVDSE measured by 2DE and RT-3DE were lower than MRI,and LVEF was higher than MRI,P0.05 respectively.After the operation,LVDVE and LVDSE measured by 2DE still lower than MRI,P0.05 respectively.There were no statistic difference for the above index between RT-3DE and MRI after the operation. Conclusion： Compared with 2DE,for large and giant LV aneurysm,RT-3DE examination is closer to MRI for assessing left ventricular volume and function,it is accurate and reliable.For giant LV aneurysm,left ventricular volume measured by 2DE and RT-3DE before the operation were both lower than MRI.

关 键 词：实时三维超声 磁共振成像 

分 类 号：R541[医药卫生—心血管疾病]