实时三维经食管超声心动图术前评价二尖瓣脱垂的准确性研究  

Real-time Three-dimensional Transesophageal Echocardiography in the Preoperative Assessment of Mitral Valve Prolapse

作　　者：陈昕[1] 杨亮[1] 冯伟[1] 李楠[1] 马春燕[1] 谷天祥[2] 杨军[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 [2]中国医科大学附属第一医院心脏外科,沈阳市110001

出　　处：《中国超声医学杂志》2012年第4期327-329,347,共4页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省自然科学基金(No.201102295)

摘　　要：目的评价实时三维经食管超声心动图(RT3D TEE)术前判断二尖瓣脱垂(MVP)区域的准确性。方法采用Philips iE33超声心动图仪,经食管三维探头X7-2t。对47例存在中至重度二尖瓣反流的MVP患者于术前进行二维经食管超声心动图(2D TEE)与RT3D TEE检查,比较2种方法判断二尖瓣脱垂区域的准确性,以术中所见做为金标准。结果 2D TEE评价MVP的敏感度、特异度、准确性、阳性预测值、阴性预测值低于RT3D TEE(90%vs 100%,96%vs99%,93%vs 99%,90%vs 98%,95%vs 100%,P<0.05)。RT3D TEE的观察者间一致性高于2D TEE(Kappa值:0.97 vs0.89,P<0.05)。结论 RT3D TEE能快速、准确地对二尖瓣脱垂进行评价。Objective To evaluate the feasibility and accuracy of using RT3D TEE to assess mitral valve prolapse （MVP） for surgical planning purposes. Methods Forty-seven consecutive patients with moderate to severe mitral re- gurgitation due to MVP received two-dimensional （2D） TEE and RT3D TEE the day before operation. The accuracy of the assessment of MVP and chordae rupture by RT3D TEE was determined and compared with assessment by 2D TEE using surgical inspection as the gold standard. Results The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 2D TEE in detection of MVP were 90%, 96%, 93%, 90% and 95%, respectively, whereas those of RT3D TEE were 100%, 99%, 99%, 98% and 100%, respectively （P〈0.05）. Interobserver agreement for RT3D TEE was significantly greater than that for 2D TEE （Kappa value： 0.97 vs 0.89,P〈 0.05）. Conclusions RT3D TEE is a fast, accurate and reproducible method for evaluating MVP in the clinical setting.

关 键 词：经食管超声心动图 二维 实时三维 二尖瓣脱垂 

分 类 号：R540.45[医药卫生—心血管疾病] R542.5[医药卫生—内科学]