经食管实时三维超声心动图对主动脉瓣环形态的可视化定量研究  

Evaluation of Aortic Annulus with Real Time Three Dimensional Transesophageal Echocardiography

作　　者：任奔[1] 康彧[1] 唐红[1] 

机构地区：[1]四川大学华西医院心内科,四川成都610041

出　　处：《西部医学》2013年第4期507-510,共4页Medical Journal of West China

基　　金：四川省科技厅科技支撑计划项目(2012FZ0065)

摘　　要：目的应用经食管实时三维超声心动图(RT 3DTEE)及其定量分析软件对主动脉瓣环进行可视化三维重建和定量分析,以期为主动脉疾病的外科及介入治疗提供更加客观、准确的依据。方法 70例行RT 3DTEE检查的患者,采集主动脉根部实时三维全容积图像,应用QLAB 7.0瓣环定量分析软件对收缩末期及舒张末期主动脉瓣环进行三维可视化重建,并测量主动脉瓣环相关参数,包括主动脉瓣环高度(H)、三维环周长(C3D)、投影平面中二维环周长(C2D)、瓣环在投影平面内的面积(A2D)以及二维环周长与三维环周长之比(C2D/C3D)。结果主动脉瓣环的三维形态与患者的瓣叶数目相关,三叶式主动脉瓣环呈三叉皇冠状,二叶式和四叶式主动脉瓣其瓣环分别呈二叉、四叉皇冠状;主动脉瓣环投影形态呈多态性,可呈椭圆形、类三角形和不规则形。主动脉瓣环参数收缩期和舒张期测值差异无统计学意义(P均>0.05)。结论 RT 3DTEE及瓣环定量分析软件能真实重建主动脉瓣环立体解剖形态,并实现瓣环定量描述。Objective In the present study, the anatomy of the aortic annulus was assessed with real time three dimensional transesophageal echocardiograhy （RT 3D TEE）. Methods A RT3D TEE was performed in 70 patients （27 men, age 14-70 years）. Of these, 17 patients had aortic diseases, 53 patients had no aortic valve diseases. All 3D images of aortic root were obtained by full volume mode, and were analysed off-line in Philips QLAB 7.0. 1） 3D reconstruction of aortic annulus. 2） The 3D structure and 2 dimensional （2D） morphology of aortic annulus in the projection plane was revealed by manually rotating the 3D reconstruction image of aortic annulus. 3） Five parameters of aortic annulus were obtained at the end of systole and distole, including annulus height （H）, the circumference of the three-dimensional view of the annulus （C3D）, the circumference of the two-dimensional view of the annulus in the projection plane （C2D）, the area of the annulus in the projection plane （A2D）, the ratio of the two-dimensional to the three-dimensional annulus circumference （C2D/C3D）. Results In patients with normal tricuspid aortic valves with or without lesions of the leaflets, the aortic annulus was a three-pronged coronet. In patients with bicuspid and quadricuspid aortic valves, the annuluses of which were two-or four-pronged coronet. The morphology of aortic annulus in the projection plane was of great variability. The were no significant difference in annulus parameters between systole and distole （all P〈0. 05）. Conclusion TEE can accurately reconstruct the 3D structure of aortic annulus and reveal the true dimension of it from any view.

关 键 词：主动脉瓣环 实时三维 经食管 超声心动图描记术 主动脉瓣疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学]