超声心动图测量右心室容积的方法学研究：与心脏磁共振比较  

Methodological research in echocardiographic measurements of right ventricular volume：compared with cardiac magnetic resonance

作　　者：李金国[1] 钟慧颖[1] 刘婷婷[1] 钟玲[1] 

机构地区：[1]福建医科大学附属协和医院心内科,福州350001

出　　处：《中华超声影像学杂志》2014年第8期662-666,共5页Chinese Journal of Ultrasonography

基　　金：福建省重点课题（2011Y0028）

摘　　要：目的 评价超声心动图多种方法测量右心室容积的准确性.方法 46例健康志愿者,男30例,女16例,年龄18～59岁,平均（34±14）岁,在24 h内进行常规二维超声心动图（2-DE）、实时三维超声心动图（RT-3DE）及心脏磁共振（cMRI）检查.2-DE计算右心室容积采用Simpson法、对切半椭圆体法和双平面面积-长度法进行.RT-3DE图像分别采用三平面成像法及TomTec 4D RV-Function CAP软件进行右室容积计算.cMRI图像采用Argus软件计算右室容积.右室容积分别测量右室舒张末期容积（RVEDV）和右室收缩末期容积（RVESV）.将超声测量结果与cMRI结果进行对比研究,两种方法的一致性评价采用Bland-Altman分析.结果 ①与cMRI相比较,Simpson法、对切半椭圆体法及三平面法所测右室容积低估,差异有统计学意义（P＜0.05）;双平面面积-长度法及TomTec 4D RV-Function CAP所测右室容积差异无统计学意义（P＞0.05）;②相关分析表明,Simpson法及三平面法与cMRI测值相关性较差（r=0.3～0.4）.TomTec 4D RV-Function CAP、对切半椭圆体法及双平面-面积长度法右心室容积测值均与cMRI右心室容积测值高度相关（r=0.7～0.8,P＜0.001）.③超声测值与cMRI测值进行Bland-Altman分析显示,TomTec法及双平面面积-长度法与cMRI的右室容积测值的平均差值更小、一致性界限更窄.结论 RT-3DE的TomTec 4D RV-Function CAP三维重建软件及2-DE的双平面面积-长度法能够准确测量右心室容积.Objective To evaluate the accuracy of methods in echocardiographic measurements of right ventricular （RV） volume.Methods Forty-six healthy volunteers were examined by two dimensional echocardiography （2-DE）,real time three-dimensional echocardiography （RT-3DE） and cardiac magnetic resonance imaging （cMRI） within 24 hours.2 DE adopts three methods to measure RV volume,the first is Simpson,the second is the half ellipsoid method,and the last is biplane area-length method.In RT 3DE,RV volume were calculated respectively by tri-plane method and TomTec 4D RV-function CAP software.In cMRI,RV volume was calculated by Argus software.Right ventricular end diastolic and end-systolic volume （RVEDV,RVESV） were measured respectively.Then the echo measurement were compared to cMRI.Consistency of two methods was evaluated by Bland-Altman analysis.Results ①As compared to cMRI,Simpson,the half ellipsoid method and tri-plane method underestimated RV volume,with statistical significance（P ＜0.05）.Biplane area-length method and TomTec 4D RV-Function CAP had no significant statistical difference （P ＞ 0.05）.② The result of correlation analysis was as follows：RV volumes from Simpson and tri-plane method had bad correlation with those from cMRI （r =0.3-0.4）.RV volumes from TomTec,half ellipsoid method and biplane area length method correlated highly with those from cMRI（r =0.7-0.8）.③The Bland-Altman analysis of echo methods with cMRI showed that each measurement by TomTec and biplane area-length method had a smaller limit of the agreement and a smaller difference average.Conclusions Tom-Tec 4D RV-Function CAP in RT-3DE and biplane area length method in 2-DE can measure RV volumes accurately.

关 键 词：超声心动描记术 右心室容积 磁共振成像 

分 类 号：R445.1[医药卫生—影像医学与核医学]