主动脉瓣病变瓣环几何构型的二维和三维经胸超声心动图研究  

Study of two-dimensional transthoracic echocardiography and real-time three-dimensional echocardiography on aortic annulus geometry of aortic valve disease

作　　者：李嵘娟[1] 王征[1] 张纯[1] 马宁[1] 吴山[1] 张涵[1] 江波[1] 李宜嘉 孙琪玮[1] 张琪[1] 杨娅[1] 

机构地区：[1]首都医科大学附属北京安贞医院超声心动图一部,北京市100029

出　　处：《临床超声医学杂志》2014年第2期78-81,共4页Journal of Clinical Ultrasound in Medicine

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2009-3-49)

摘　　要：目的探讨实时三维经胸超声心动图(RT-3D-TTE)观察主动脉瓣病变患者瓣环几何构型的临床应用价值。方法选择主动脉瓣病变拟行主动脉瓣置换术的患者45例为病变组,年龄、性别相匹配的体检健康者40例为对照组。术前行二维经胸超声心动图(2D-TTE)和RT-3D-TTE测量主动脉瓣环径,术中应用外科测瓣器测量瓣环径。结果病变组2D-TTE、RT-3D-TTE矢状面、冠状面及手术中直径分别为(24.92±5.52)mm、(25.32±4.54)mm、(26.72±4.54)mm和(27.02±3.43)mm,2D-TTE直径小于RT-3D-TTE直径及手术中直径(P<0.05)。2D-TTE、RT-3D-TTE直径与手术中直径之间均具有相关性,RT-3D-TTE冠状面直径相关性最佳(r为0.842)。两组冠状面直径大于矢状面直径(P<0.05),病变组RT-3D-TTE冠状面直径大于对照组(P<0.05)。结论主动脉瓣环近似椭圆形,冠状面直径较大。RT-3D-TTE测量的主动脉冠状面直径与手术中直径相关性最佳,对主动脉瓣置换术瓣膜大小的选择有参考意义。Objective To investigate clinic application value on annulus geometry in patients with aortic valve disease using real-time three-dimensional transthoraeic eehocardiography （RT-3D-TrE）. Methods Forty-five patients scheduled to have aortic valve operation were enrolled as observation group received 2D-TIE and RT-3D-TYE before operation. Forty healthy adults matching with age and gender were enrolled as control group received 2D-TFE and RT-3D-TrE. Valve annulus diameters in observation group were measured by cylindrical sizers during operation. Results The diameter of aortic annulus measured by 2D-TFE was （24.92＋5.52）mm. The annulus diameters of sagittal view and coronal view which measured by RT-3D-TrE were （25.32~4.54）mm and （26.72~5.22）mm, respectively. The diameter of aortic annulus measured by cylindrical sizers during operation was （27.02~3.43）mm. The diameter of aortic annulus measured by 2D-TlrE was smaller than by RT-3D-TFE and cylindrical sizers during operation （P〈0.05）. 2D-TFE,RT-3D-TYE and operational assessment of aortic annulus had good correlation. The diameters of coronal view measured by RT-3D-TI＇E had the largest correlation with operational assessment （r=0.842）.The annulus diameters of coronal view were larger than those of sagittal view in the two groups（P〈0.05）. The diameters of coronal view in observation group were larger than control group （P〈0.05）. Conclusion The shape of aortic annulus was near elliptical. The diameter of coronal view was larger than sagittal view. The diameter of coronal view measured by RT-3D-TrE had the largest correlation with operational assessment, which might be great help for selecting valve needed by aortic valve replacement.

关 键 词：超声心动描记术 二维 三维 主动脉瓣 瓣环 

分 类 号：R540.45[医药卫生—心血管疾病]