经食管三维超声测量主动脉瓣环及冠状动脉开口高度：与CT对照研究  

Comparison study of three-dimensional transesophageal echocardiography and CT in measuring the size of aortic ring and the height of coronary ostium

作　　者：潘翠珍[1] 杨雪[2] 周年伟 周达新[3] 潘文志[3] 赵维鹏[1] 孔德红[1] 罗红[4] 舒先红[1] 

机构地区：[1]复旦大学附属中山医院上海市影像医学研究所上海市心血管病研究所心超室,上海200030 [2]复旦大学附属中山医院上海市影像医学研究所上海市心血管病研究所放射科,上海200030 [3]复旦大学附属中山医院上海市影像医学研究所上海市心血管病研究所心内科,上海200030 [4]复旦大学附属中山医院上海市影像医学研究所上海市心血管病研究所麻醉科,上海200030

出　　处：《中华超声影像学杂志》2016年第12期1021-1025,共5页Chinese Journal of Ultrasonography

基　　金：上海市科学技术委员会资助项目（14411962500）

摘　　要：目的对比研究经食管三维超声心动图（3DTEE）分析软件和计算机断层扫描（MDCT）评价主动脉瓣环大小及左右冠状动脉开口高度的差异。方法对15例行经导管主动脉瓣植入（TAVI）患者，术前均行常规经胸超声心动图、经食管二维超声心动图（2DTEE）、3DTEE及MDCT检查。结果3DTEE测得的主动脉瓣环最小径、最大径、周长、面积与MDCT测值有很高的相关性和一致性[r=0．88，P〈0．0001，ICC=0．928（0．788～0．976）；r=0．81，P=0．0003，ICC=0．890（0．673～0．963）；r=0．85，P=0．0001，ICC=0．914（0．744～0．971）；r=0．88，P〈0．0001，ICC=0．932（0．799~0．977）]；3DTEE测得的左冠状动脉开口高度、右冠状动脉开口高度与MDCT测值有很高的相关性和一致性[r=0．87，P〈0．0001，ICC：0．923（0．777～0．975）；r=0．82，P〈0．0002，ICC=0．897（0．693~0．965）]；3DTEE测量主动脉瓣环最小径、最大径、周长、面积以及左右冠状动脉开口高度的观察者内、观察者间有很好的相关性和一致性。结论3DTEE分析软件评价主动脉瓣环直径、周长、面积以及左右冠状动脉开口高度具有较高的重复性，并且与MDCT测值有很好的相关性。Objective To investigate the difference between three-dimensional transesophageal echocardiography （3DTEE） and CT in measuring the size of aortic ring and the height of coronary ostium. Methods Fifteen patients were recruited and were treated with the transcatheter aortic valve implantation （TAVI）. Routine transthoracic echocardiography, two-dimensional echocardiography （2DTEE）, 3DTEE and CT examinations were taken preoperatively. Results The minimal diameter, maximum diameter, perimeter, area of the aortic ring measured by 3DTTE showed a close correlation and a strong consistency with those measured by CT [ r = 0.88, P 〈0.0001,ICC= 0.928 （0.788 - 0.976） ; r = 0.81, P = 0.0003, ICC=0.890 （0.673- 0.963）, r = 0.85, P = 0.0001,ICC= 0.914 （0.744- 0.971）; r = 0.88, P 0. 0001, ICC = 0. 932 （0. 799- 0. 977）]. The ostium height of the left and right coronary arteries measured by 3DTEE also showed a close correlation and a strong consistency with those measured by MDCT [ r = 0.87, P 〈0.000I,ICC=0.923 （0.777-0.975）; r =0.82, P 〈0.0002,ICC =0.897 （0.693-0.965）]. Besides,inter-observer and intra-observer reproducibility for 3DTEE measurement data were very good. Conclusions 3DTEE has a high repeatability in evaluating minimal diameter, maximum diameter, perimeter, area of the aortic ring and the height of coronary ostium, which also shows good correlation with those measured by CT.

关 键 词：超声心动描记术 经食管 实时三维 主动脉瓣 心脏瓣膜假体植入 

分 类 号：R540.45[医药卫生—心血管疾病]