经食管实时三维超声心动图评价无明显二尖瓣病变的中重度二尖瓣反流患者的二尖瓣构型  

Evaluation of Mitral Valve Configuration in Patients with Moderate to Severe Mitral Regurgitation Without Obvious Mitral Valve Disease by Real-Time Three-Dimensional Transesophageal Echocardiography

作　　者：盛宗祥 冉红[1] 董静[1] 王涵 费梦瑶 张平洋[1] SHENG Zongxiang;RAN Hong;DONG Jing;WANG Han;FEI Mengyao;ZHANG Pingyang(Department of Cardiovascular Ultrasound,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing First Hospital,Nanjing 210029,China)

机构地区：[1]南京医科大学附属南京医院心血管超声科南京市第一医院,江苏南京210029

出　　处：《中国医学影像学杂志》2022年第6期548-553,共6页Chinese Journal of Medical Imaging

摘　　要：目的探讨经食管实时三维超声心动图(RT-3D-TEE)定量评价无明显二尖瓣病变的中重度二尖瓣反流患者的二尖瓣构型。资料与方法回顾性分析2018年5月—2021年8月于南京市第一医院行二维经胸超声心动图检查未见明显二尖瓣瓣叶病变并伴有中重度二尖瓣反流患者29例作为研究组,以经RT-3D-TEE检查未发现心脏病变的30例患者作为对照组,两组均行RT-3D-TEE检查,观察二尖瓣的形态特点。分析二尖瓣参数与MR程度的相关性。结果研究组左心房大小、瓣环面积、前叶瓣环周长、后叶瓣环周长、瓣环周长、瓣环前后径、瓣环前外侧-后内侧径大于对照组(t=3.44~5.26,P均<0.05)。研究组前叶A1、A2、A3区面积、后叶P1、P2、P3区面积大于对照组(t=3.24~6.91,P均<0.05)。二尖瓣面积对合指数小于对照组[(24.1±2.5)%比(29.6±1.4)%;t=−10.28,P<0.05]。二尖瓣面积对合指数与反流程度呈负相关(r=−0.923,P<0.05);瓣环面积、瓣环前后径、瓣环前外侧-后内侧径、前叶瓣环周长、后叶瓣环周长、瓣环周长、前叶A1、A2、A3区面积、后叶P1、P2、P3区面积与二尖瓣反流程度呈正相关(r=0.596、0.506、0.622、0.609、0.547、0.595、0.663、0.395、0.722、0.703、0.640、0.559,P均<0.05)。结论临床认为无明显二尖瓣病变的中重度二尖瓣反流患者通过RT-3D-TEE检查发现,二尖瓣瓣环存在一定程度增大及二尖瓣面积代偿性增大。RT-3D-TEE可以评价中重度二尖瓣反流患者的二尖瓣构型。Purpose To investigate the quantitative evaluation of mitral valve configuration in patients with moderate and severe mitral regurgitation without obvious mitral valve disease by real-time three-dimensional transesophageal echocardiography(RT-3D-TEE),and analyze the related data,so as to provide reference for clinical diagnosis and treatment.Materials and Methods From May 2018 to August 2021,29 patients with moderate and severe mitral regurgitation without obvious mitral valve disease were examined by two-dimensional transthoracic echocardiography in Nanjing First Hospital,and 30 patients without heart disease by RT-3D-TEE were used as control group.The morphological characteristics of mitral valve were observed and compared between the two groups by RT-3D-TEE.The correlation between mitral valve parameters and MR degree was also analyzed.Results The size of left atrium,annulus area,circumference of anterior annulus,circumference of posterior annulus,circumference of annulus,anterior to posterior diameter and anterolateral to posterior medial diameter of annulus in study group were statistically larger than those in control group(t=3.44-5.26,all P<0.05).The area of A1,A2 and A3 area of anterior lobe,P1 P2 and P3 area of posterior leaf in the study group were larger than those in the control group(t=3.24-6.91,all P<0.05),the difference was statistically significant.The mitral valve area involution index in the control group was significantly lower than that in the control group[(24.1±2.5)%vs.(29.6±1.4)%;t=−10.28,P<0.05].Mitral valve area involution index was negatively correlated with regurgitation degree(r=−0.923,P<0.05).Annulus area,anterior to posterior diameter,anterolateral to posterior medial diameter,circumference of anterior annulus,circumference of posterior annulus,circumference of annulus,A1,A2 and A3 area of anterior lobe,P1,P2 and P3 area of posterior leaf were positively correlated with the degree of mitral regurgitation(r=0.596,0.506,0.622,0.609,0.547,0.595,0.663,0.395,0.722,0.703,0.640,0.559,

关 键 词：二尖瓣反流 超声心动描记术 三维 二尖瓣构型 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.5[医药卫生—诊断学]