实时三维心脏超声评估法洛四联症术后右心功能的价值  

Role of real-time three dimensional echocardiography in the assessment of right ventricular function of re- paired tetralogy of Failot

作　　者：张惠锋[1] 贾兵[1] 叶明[1] 陈张根[1] 梁雪村[1] 

机构地区：[1]复旦大学附属儿科医院心胸外科,上海201102

出　　处：《中华实用儿科临床杂志》2014年第11期825-827,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨实时三维心脏超声（RT-3DE）与电影磁共振（c—MRI）比较，在评估法洛四联症（TOF）术后右心功能中的应用价值。方法2000年1月至2007年6月在复旦大学附属儿科医院心血管中心接受一期根治手术的37例TOF患儿同时接受了RT-3DE和c—MRI检查，分别测定右心室舒张末期容积（RVEDV）、右心室收缩末期容积（RVESV）、右心室射血分数（RVEF），分析2种技术在右心功能评价中的一致性及相关程度。结果与c—MRI比较，RT-3DE在测量RVEDV、RVESV、RVEF上均有很好的相关性（r=0．933、0．943、0．911，P=0．000、0．000、0．105），能比较准确地反映RVEF，差异值仅为（1．2±4．5）％，但在RVEDV和RVESV上均被低估，分别低估约（-17．4±16．9）mL和（-9．3±10．5）mL。结论RT-3DE与c—MRI比较，评估TOF术后右心容积和功能具有较高的相关性，能够准确反映RVEF，但在RVEDV、RVESV上存在低估，需要进一步研究来确定其在TOF术后右心功能评价上的可行性。Objective To evaluate the clinical value of real-time 3 dimensional echocardiography （RT-3DE） for measurement of right ventricular function in the repaired tetralogy of Fallot （TOF） compared to cine magnetic reso- nance imaging （e-MRI）. Methods Thirty-seven randomly selected patients with repaired TOF from Jan. 2000 to Jun. 2007 in Children＇s Hospital,Fudan University underwent both RT-3DE and c-MRI for the data of right ventricular end- diastolic volume （RVEDV）, right ventricular end-systolic volume （RVESV）, right ventrieular ejection fraction （RVEF） , which were compared to evaluate the reproducibility and correlation of two ways on right ventrieular function. Results All the patients completed both RT-3DE and c-MRI on the same day. The correlation for RVEDV, RVESV, RVEF measured by 2 methods was high （r = 0. 933,0. 943,0.911 ,P = 0. 000,0. 000,0. 105 ） ,and it showed that con- sistency existed in RVEF, as difference was only （ 1.2 ± 4.5 ） %. Comparison with c-MRI, RVEDV and RVESV mea- sured by RT-3DE was underestimated,in which difference was （ - 17.4 ± 16.9） mL, （ - 9.3 ± 10.5 ） mL. Conclu- sions RVEF with RT-3DE can be assessed with acceptable accuracy,but it is not so good for RVEDV and RVESV. Further study needs to be performed to make sure the value of RT-3DE on the assessment of right ventricular function in repaired TOF.

关 键 词：实时三维心脏超声 法洛四联症 心脏磁共振 右心功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.5[医药卫生—诊断学]