实时三维超声结合超声造影评价心肌致密化不全患者左心室容积和功能  

Assessment of left ventricular volume and function in patients with left ventricular non-compaction by contrast-enhanced three-dimensional echocardiography

作　　者：邱林立[1] 谢明星[1] 王新房[1] 吕清[1] 李玲[1] 杨亚利[1] 袁莉[1] 孙振兴[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声诊断科,湖北省分子影像重点实验室,武汉430022

出　　处：《中华超声影像学杂志》2014年第11期921-924,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨实时三维超声心动图（RT-3DE）结合超声造影（CE-3DE）评价左室心肌致密化不全（LVNC）患者左室容积和功能的应用价值。方法应用RT-3DE与CE-3DE分别测量21例LVNC患者左室舒张末期容积（LVEDV）、收缩末期容积（LVESV）和射血分数（LVEF）。分别在无造影和造影状态下行三维超声显像，按16节段法对左室各个节段边界显示情况进行评分：0分，边界显示不清；1分，边界显示不完全；2分，边界完全显示。根据评分将三维图像质量定义为好、一般、差三个等级。结果①与RT-3DE相比，CE-3DE成像左室节段心内膜边界完全显示的比例显著增加（82％对55％，P〈0．01），三维图像质量好的比例显著增加（81％对33％，P〈0．01）。②与RT-3DE相比，CE-3DE所测LVEDV与LVESV均增加，差异有统计学意义[（137．31±59．47）ml对（126．25±59．67）ml，P〈0．01；（77．44±56．57）ml对（68．79±52．74）ml，P〈0．01]；但两种方法所测LVEF之间差异无统计学意义[（48．19±14．02）％对（50．17±13．47）％，P=0．07]。③较之RT一3DE，CE-3DE所测量左室容积和功能参数的观察者内及观察者间一致性均显著提高。结论CE-3DE可显著提高LVNC患者的三维图像质量以及LVNC患者左室容积和功能测量的重复性。Objective To evaluate the value of echo-contrast RT-3DE for assessment of left ventricular volume and function in patients with left ventricular non-compaction（LVNC）.Methods Twenty- one patients of LVNC were involved and underwent non-enhanced and contrast-enhanced RT-3DE to evaluate left ventricular end-diastolic volume （LVEDV）,left ventricular end-systolic volume （LVESV）,left ventricular ejection fraction （LVEF）.The endoeardial border definition of LV was graded for each of the 16 LV segments as follows： 0 = border invisible, 1 = border visualized only partially, and 2 = complete visualization of the border. Three image-quality groups （good, fair, and uninterpretable） were identified. Results ① During contrast-enhanced RT-3DE, as compared with non-enhanced RT-3DE, the number of segments with complete visualization of the endocardial border increased significantly （55 % vs 82%, P〈 0.01）, and the number of patients with a good-quality echocardiogram increased significantly （33 % vs 81 %, P 〈0.01）.②Contrast-enhanced RT-3DE provided significantly larger values of LVEDV （ P 〈0.01） and LVESV （ P 〈0.01） as compared with non-enhanced RT-3DE, the values of LVEF were not statistically different between the two techniques （ P = 0.07）.③Intra- and inter-observer agreement for assessment of LV volumes and systolic function improved during contrast-enhanced RT-3DE, as compared with non- enhanced RT-3DE. Conclusions Contrast-enhanced RT-3DE can increase the prevalence of good-quality echocardiograms and significantly improve the reproducibility of LV volumes and function measurements.

关 键 词：超声心动描记术 实时三维 微气泡 心室肌致密化不全 心室功能 左 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]