实时三维经食管超声心动图及经胸超声心动图与二维经胸超声心动图评价二尖瓣脱垂精细定位的价值研究  

The Value of Real-time Three-dimensional Transesophageal Echocardiography,Transthoracic Echocardiography and Two-dimensional Transthoracic Echocardiography for Fine Localization of Mitral Valve Prolapse

作　　者：文鼎华[1] 刘晓真[1] 叶木奇[1] WEN Ding-hua;LIU Xiao-zhen;YE Mu-qi(Ultrasound Imaging Department,Zhongshan People's Hospital,Guangdong 528401,China)

机构地区：[1]中山市人民医院超声影像科,广东528401

出　　处：《影像技术》2023年第2期55-59,共5页Image Technology

摘　　要：目的:探讨实时三维经食管超声心动图及经胸超声心动图与二维经胸超声心动图评价二尖瓣脱垂精细定位的价值。方法:回顾性分析2018年7月-2022年3月我院90例二尖瓣脱垂患者临床资料。全部患者均接受实时三维经食管超声心动图、经胸超声心动图、二维经胸超声心动图检查并由专业医师判断脱垂定位情况。比较三种检查方式诊断效能及定位准确率。结果:术后检出二尖瓣脱垂为90例且均合并腱索断裂,其中多区域脱垂为67例,单瓣叶单区域脱垂为23例,实时三维经食管超声心动图对多区域(100%)、二尖瓣脱垂及合并腱索断裂(100%)定位准确率明显高于二维经胸超声心动图(t=9.997,9.986,9.995,P均<0.001)。实时三维经食管超声心动图对A2及A3区、P1及P2区的定位敏感性、特异性、阳性预测值、阴性预测值、准确率均高于对照组(t=9.964,9.959,9.425,9.446,9.971,9.880,9.994,9.996,9.981,9.990,P均<0.01)。金标准检出后叶脱垂分别为:P1区10例、P2区27例、P3区12例,前叶脱垂分别为:A1区12例、A2区27例、A3区2例。金标准检出吊床样脱垂20例,倾斜状脱垂33例。实时三维经食管超声心动图对前、后叶脱垂及脱垂形态的检出优势明显高于二维经胸超声心动图(P<0.05)。结论:实时三维经食管超声心动图及经胸超声心动图对多区域二尖瓣脱垂定位优势明显,而二维经胸超声心动图对多瓣叶脱垂情况定位无优势,适合单瓣叶脱垂情况评估。Objective:To investigate the value of real-time three-dimensional transesophageal echocardiography and transthoracic echocardiography versus two-dimensional transthoracic echocardiography in evaluating the fine localization of mitral valve prolapse.Methods:The clinical data of 90 patients with mitral valve prolapse in our department from July 2018 to March 2022 were retrospectively analyzed.All patients underwent real-time 3D transesophageal echocardiography,transthoracic echocardiography,and 2D transthoracic echocardiography and had their prolapse localization determined by a specialist physician.The diagnostic performance and localisation accuracy of the three modalities were compared.Results:90 cases of mitral valve prolapse were detected after surgery,all of which were complicated with chordae tendinae rupture,among which 67 cases were multi-zone prolapse and 23 cases were single-lobe single zone prolapse.The localization accuracy of real-time three-dimensional transesophageal echocardiography for multi-zone(100%),mitral valve prolapse and chordae tendae rupture(100%)was significantly higher than that of two-dimensional transthoracic echocardiography(t=9.997,9.986,9.995,all P<0.001).Real-time three-dimensional transesophageal echocardiography showed higher localization sensitivity,specificity,positive predictive value,negative predictive value and accuracy in A2 and A3,P1 and P2 regions than in the control group(t=9.964,9.959,9.425,9.446,9.971,9.880,9.994,9.996,9.981,9.990,P<0.01).Posterior lobe prolapse was detected by gold standard in 10 cases in area P1,27 cases in area P2,12 cases in area P3,and 12 cases in area A1,27 cases in area A2,and 2 cases in area A3.Gold standard found 20 cases of hammock prolapse and 33 cases of tilting prolapse.Real-time three-dimensional transesophageal echocardiography(P<0.05).Conclusion:Real-time 3D transesophageal echocardiography and transthoracic echocardiography have a significant advantage in locating multi-regional mitral valve prolapse,whereas 2D transthoracic echocard

关 键 词：实时三维经食管超声心动图 精细定位 实时三维经胸超声心动图 二尖瓣脱垂 

分 类 号：R445.1[医药卫生—影像医学与核医学]