经食管三维超声灰阶反转容积再现显像评价心房颤动患者左心耳空间解剖：与CT对比研究  

Volume rendered imaging of three dimensional transesophageai echocardiography with grey values inverted in assessment of morphology of left atrial appendage in patients with atrial fibrillation： a comparison with CT

作　　者：宋宏宁[1] 周青[1] 陈金玲[1] 胡波[1] 谭团团[1] 张兰[1] 郭瑞强[1] 

机构地区：[1]武汉大学人民医院超声影像科,430060

出　　处：《中华超声影像学杂志》2016年第2期110-115,共6页Chinese Journal of Ultrasonography

摘　　要：目的通过经食管三维超声的新型灰阶反转成像（3D-GVI）获取左心耳容积再现模型，并与心脏CT造影成像对比，评估左心耳的空间解剖形态。方法对40例房颤患者进行经食管超声（TEE）和CT检查。获取经食管3D左心耳图像数据，对超声图像进行灰阶反转和阈值分割，得到左心耳容积显像，评价左心耳解剖形态、分叶数，测量开口径线，并与CT容积成像（CT—VR）和CT测量值进行对比。结果应用3D-GVI和CT均成功获取40例患者左心耳解剖学信息和三维重建模型。3D-GVI评估左心耳空间构型与CT的一致性为97．5％，评价左心耳分叶数与CT的一致性为92．5％。3D-GVI测量左心耳开口长轴、短轴、深度及开口面积小于CT（P〈0．01），CT与超声测量左心耳存在一致性。结论应用新型TEE3D-GVI可实现左心耳腔室的三维空间重建，获得类似CT—VR成像的效果，有望成为左心耳空间形态评估的首选方法。Objective To acquire volume rendered images of left atrial appendage （LAA） chambers by three dimensional transesophageal echocardiography （3DTEE） using a novel image mode of grey values inverted imaging （GVI）. Methods Forty patients with atrial fibrillation were performed with TEE and cardiac CT examination before intervention treatment. Three-dimensional transesophageal echocardiography images were acquired and displayed as a gray values inverted mode. Threshold segmentation and interactive segmentation were used to 3D digital replicas of LAA chambers. Morphology information including morphology type of LAAs and number of lobes and measurements of LAAs were recorded and compared with CT volume reconstruction（CT-VR） images. Results Morphology information and measurements were successfully acquired by CT and 3DTEE-GVI images in all 40 cases. The consistence of LAA morphology type by 3D-GVI and CT was 97.5 %. The consistence of number of LAA lobes by 3D-GVI and CT was 92.5%. The measurements of long axis, short axis, area of ostiums of LAAs, and depth of LAAs by CT were larger than those by 3D-GVI （P 〈 0.01 ）. There were agreements between two methods of measurement. Conelusions LAA chambers can be reconstructed by 3D TEE-GVI, which can achieve similar effect to CT-VR. 3DTEE-GVI promises to be one of the most effective methods in assessment of LAAs＇ morphology information for planning of LAA occlusion.

关 键 词：超声心动描记术 左心耳 灰阶反转成像 

分 类 号：R541.75[医药卫生—心血管疾病] R540.45[医药卫生—内科学]