经胸超声心动图二维及三维增强成像技术评估犬左室结构及功能的实验研究  

Evaluation of left ventricular structure and function in beagles by two-and three-dimensional contrast-enhanced transthoracic echocardiography:an experimental study

作　　者：周燕翔 熊叶 宋弯弯 杨远婷 易仁凤 曹省[1] 郭瑞强[1] 周青[1] ZHOU Yanxiang;XIONG Ye;SONG Wanwan;YANG Yuanting;YI Renfeng;CAO Sheng;GUO Ruiqiang;ZHOU Qing(Department of Ultrasonography,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院超声影像科,武汉市430060

出　　处：《临床超声医学杂志》2020年第6期401-406,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用经胸超声心动图二维及三维增强成像技术评估犬左室结构及功能的准确性和可重复性。方法采集12只比格犬左室长轴切面腱索水平M型图像,以及非增强和增强模式下以左心为主的心尖四腔、三腔、两腔切面及三维全容积图像。分别判断二维超声心动图(2DE)、三维超声心动图(3DE)非增强及增强模式下左室心尖四腔、三腔、两腔及整体心内膜显示的节段数,并测量2DE非增强及增强模式下左室舒张末期长径(LVLD)。分别采用M型Teichholz公式、非增强及增强模式下双平面Simpson法测量左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF);采用TomTec软件对左室三维全容积图像进行后处理分析,分别测量3DE非增强及增强模式下LVEDV、LVESV、LVEF。以解剖标本测值为金标准,评价不同方法测量LVLD、LVEDV的准确性。评价同一观察者内及不同观察者间各方法测量LVEDV、LVESV及LVEF的可重复性。结果①2DE及3DE增强模式对左室壁节段心内膜显示优于非增强模式,以2DE增强模式为最佳(均P<0.05);②2DE增强模式所测LVLD与解剖标本长径测值相关性系数较非增强模式高(0.851 vs.0.748),M型、2DE、3DE非增强及增强模式下LVEDV测值与解剖标本测值的相关性系数分别为0.612、0.806、0.857、0.728、0.869(均P<0.05),增强模式下测值准确性较非增强模式高,以3DE增强模式最高;③2DE及3DE增强模式测量LVEDV、LVESV、LVEF的可重复性高于M型及非增强模式,其变异系数均更小,以3DE增强模式最小。结论经胸超声心动图增强成像技术可以改善2DE及3DE图像质量,提高犬左室结构及功能相关参数的测量准确性及可重复性,为临床精确评估及动态监测左室结构及功能提供了新方法。Objective To discuss the accuracy and repeatability of left ventricular structural and functional measurements in beagles by two-and three-dimensional contrast-enhanced transthoracic echocardiography(2D cTTE and 3D cTTE).Methods M-mode images in parasternal long-axis view were obtained from 12 beagles,and the apical four-chamber,three-chamber and two-chamber views and the three-dimensional full-volume images of the left ventricle were collected by unenhanced and contrast-enhanced transthoracic echocardiography.The intimal display rates in apical four-chamber,threechamber and two-chamber views of the left ventricular segment were evaluated by two-and three-dimensional echocardiography(2DE and 3DE).Left ventricular end diastolic longitudinal diameter(LVLD)was measured by 2DE and 2D cTTE.Left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)and left ventricular ejection fraction(LVEF)were measured respectively by Teichholz method of M mode,biplane Simpson method of 2DE and 2D cTTE.Left ventricular threedimensional full-volume images were processed and analyzed by TomTec software,LVEDV,LVESV,LVEF were measured respectively by 3DE and 3D cTTE.The measurements of pathological specimen were taken as the gold standard,the accuracies of measuring LVLD and LVEDV by different methods were evaluated.All indexes were measured again by the same observer and different observers,and the repeatability of different methods for measuring different indexes was evaluated.Results①The intimal display rate of the left ventricular segment was higher by 2D cTTE and 3D cTTE than those by 2DE and 3DE,2D cTTE was the best(all P<0.05).②The measurements of LVLD by 2D cTTE was more relevent with the measurements by pathological specimen than that by 2DE(0.851 vs.0.748).The measurements of LVEDV by M mode,2DE,2D cTTE,3DE and 3D cTTE were correlated with the measurements by pathological specimen(r were 0.612,0.806,0.857,0.728,0.869,all P<0.05).2D cTTE and 3D cTTE could provide more accurate measurements,3D cT

关 键 词：超声心动描记术 经胸 超声增强剂 心室功能 左 犬 

分 类 号：R540.45[医药卫生—心血管疾病] R-33[医药卫生—内科学]