全自动量化经胸三维超声心动图评估心血管病患者左心室功能的可行性探讨  

Feasibility of evaluating the left ventricular function in patients with cardiovascular diseases by fully automatic quantified three-dimensional transthoracic echocardiography

作　　者：荆波 田园 孙媛媛 宋瑜 Jing Bo;Tian Yuan;Sun Yuanyuan;Song Yu(Department of Ultrasound Medicine,Affiliated Cardiovascular Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属心血管病医院超声医学科,361000

出　　处：《中华心血管病杂志》2020年第9期753-758,共6页Chinese Journal of Cardiology

摘　　要：目的探讨全自动量化经胸三维超声心动图(简称为全自动三维超声心动图)评估心血管病患者左心功能的准确性与可重复性。方法回顾性纳入2017年9月至2019年5月厦门大学附属心血管病医院收治的心血管病患者197例,均行经胸三维超声心动图检查,其中心脏模型超声图像质量1级共61例被用于确定心内膜舒张末期和收缩末期默认边界值。通过电子病例系统收集入选者的一般临床资料。以常规手动经胸三维超声心动图(简称为手动三维超声心动图)测量值作为标准,评价全自动三维超声心动图测量左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和左心室射血分数(LVEF)的准确性及可重复性。结果全自动三维超声心动图测量的LVEDV、LVESV和LVEF与手动测量值均呈正相关(P均<0.05)。但是,全自动三维超声心动图测量的LVEDV和LVESV均明显大于手动测量值(P均<0.05)。全自动与手动三维超声心动图评价心室壁运动异常患者收缩功能损伤程度的一致性,经手动校准后(κ=0.74,P=0.00)优于手工校正前(κ=0.63,P=0.00)。全自动三维超声心动图检测LVEDV、LVESV和LVEF的观察者间和观察者内变异度均小于手动三维超声心动图(P均<0.05)。结论采用全自动三维超声心动图测量心血管病患者左心室功能的准确性和重复性均良好,临床应用具有可行性。Objective To investigate the clinical value of left ventricular function assessment in patients with cardiovascular disease by fully automatic quantified three-dimensional transthoracic echocardiography.Methods One hundred and ninety-seven patients with cardiac diseases were examined by three-dimensional transthoracic echocardiography from September 2017 to May 2019.Data from 61 patients with grade 1 echocardiographic image quality were used to determine the default boundary values of endocardial end-diastolic and end-systolic phases.Clinical features were analyzed based on electronic medical records.The accuracy and repeatability of this strategy was evaluated by comparing left ventricular end-diastolic volume(LVEDV),end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF)measured by automated quantitative three-dimensional echocardiography and those measured by conventional manual transthoracic echocardiography,the latter served as gold standard.Results The levels of LVEDV,LV ESV and LVEF measured by automatic three-dimensional echocardiography were positively correlated with values obtained by manual measurement(r=0.97,0.97,0.98,0.97,0.97,0.96;P<0.05).The levels of LVEDV and LVESV measured by full-automatic three-dimensional echocardiography were significantly higher than those obtained by manual three dimensional echocardiography(all P<0.05).The classification and correlation of systolic dysfunction in patients with abnormal ventricular wall motion by automatic three-dimensional echocardiography were significantly improved after manual calibration(K=0.74,P=0.00)as compared to without manual calibration(K=0.63,P=0.00).The inter-observer and intra-observer variability of fully automated three-dimensional echocardiography were significantly smaller than manual three-dimensional echocardiography(both P<0.05).Conclusion Fully automatic quantified three-dimensional transthoracic echocardiography possesses excellent accuracy and repeatability in measuring left ventricular volume and function,and it is

关 键 词：心血管疾病 心室功能 左 左心室容积 全自动量化经胸三维超声心动图 

分 类 号：R540.45[医药卫生—心血管疾病]