四维左心房自动定量分析技术评价左心房容积及功能的临床研究  

Clinical Investigation on Foure-dimensional Left Atrial Automatic Quantitative Technology in Evaluating Left Atrial Volume and Function

作　　者：汤跃跃 杨寒凝 金有靓 李淑敏 陆永萍 TANG Yueyue;YANG Hanning;JIN Youliang;LI Shumin;LU Yongping(Dept.of Ultrasound,Affiliated Hospital of Yunnan University/The 2nd People’s Hospital of Yunnan Province,Kunming Yunnan 650021,China)

机构地区：[1]云南大学附属医院/云南省第二人民医院超声科,云南昆明650021

出　　处：《昆明医科大学学报》2023年第7期57-63,共7页Journal of Kunming Medical University

基　　金：云南省医学学科后备人才培养基金资助项目(H-2018011);云南省万人计划基金资助项目(YNWR-MY-2018-004)。

摘　　要：目的探讨四维左心房自动定量(4D Auto LAQ)技术对非选择性连续患者左心房的容积及功能的应用价值。方法187例入选患者中成功分析143例患者。应用4D Auto LAQ技术及Simpson’s双平面技术分别获取左房整体射血分数(LAEF)、左房最大容积指数(LAVImax)、左心房舒张末期容积(LAVmax)、左心房收缩末期容积(LAVmin),同时记录分析时间,比较2种技术所测参数的准确性及可重复性。结果4D Auto LAQ技术及Simpson’s双平面技术所测值相关性高(r值:LAVmax 0.91,LAVmin 0.89,LAVI0.90,LAEF 0.54;P<0.01)、一致性较好[平均测量差异:LAVmax10.1 mL,LAVmin 3.1 mL,LAVI 6.4 mL,LAEF 10.0%;一致性区间:LAVmax(-30.7-50.9)mL,LAVmin(-32.2-38.4)mL,LAVI(-21.2-34.1)mL,LAEF(-19.8-39.8)%]。4D Auto LAQ技术对不同心动周期各测量值相关性好(r值:LAVmax 0.99,LAVmin 0.98,LAVImax 0.99,LAEF 0.92;P<0.01),一致性区间为[LAVmax(-8.9-7.9)mL,LAVmin(-7.9-10.8)mL,LAVI(-7.9-10.8)mL/m2,LAEF(-14.8-9.1)%]。4D Auto LAQ技术各测量值在观察者内部、观察者间的重复性均较好(组内相关系数均>0.8,变异系数均<10%),且优于Simpson’s双平面法。4D Auto LAQ技术技术用时较Simpson’s双平面法明显减少,分别为(30.87±5.05)s、(60.20±5.05)s,(P<0.05)。结论4D Auto LAQ技术评价左心房容积及功能用时更短,重复性好,具有临床推广价值。Objective To explore the role of four-dimensional left atrial automatic quantitative technology in evaluating the volume and function of the left atrium in non-selective continuous patients,and to preliminarily explore its accuracy and repeatability.Methods Foure-dimensional left atrial full-volume dynamic images of 187 consecutive patients were collected,44 patients who failed the analysis were excluded,and 143 were successfully analyzed.Using Simpson’s biplane method as the reference standard,the 4D Auto LAQ technology was used to evaluate the left atrial end-diastolic volume(LAVmax),left atrial end-systolic volume(LAVmin),left atrial maximum volume index(LAVImax),and left atrial global ejection fraction.(LAEF)accuracy and repeatability.Results In all patients who were successfully analyzed,the inter-technique comparisons showed good correlations(R-values:LAVmax 0.91,LAVmin 0.89,LAVI 0.90,LAEF 0.54;all P<0.01),small biases(LAVmax 10.1 mL,LAVmin 3.1 mL,LAVI 6.4 mL,LAEF 10.0%;Concordance interval:LAVmax(-30.7-50.9)mL,LAVmin(-32.2-38.4)mL,LAVI(-21.2-34.1)mL,LAEF(-19.8-39.8)%]for all measurements in all patients.4D Auto LAQ technology showed good correlation between the parameters of different cardiac cycles(r value:LAVmax 0.99,LAVmin 0.98,LAVImax 0.99,LAEF 0.92;all P<0.01),and the average measurement difference did not exceed two measurement units(1 mL/volume,1%/LAEF),the consistency interval is also narrow[LAVmax(-8.9-7.9)mL,LAVmin(-7.9-10.8)mL,LAVI(-7.9-10.8)mL/m^(2),LAEF(-14.8-9.1)%.The intra-and inter-observer repeatability of each parameter of 4D Auto LAQ technology was good(within-group correlation coefficients were all>0.8,0.81-0.99,and coefficients of variation were all<10%),and it was better than Simpson’s biplane method.Compared with Simpson’s biplane method,the time of 4D Auto LAQ quantitative technology was significantly reduced,which were(30.87±5.05)s and(60.20±5.05)s respectively(P<0.05).Conclusions Since4D Auto LAQ technology can be widely used in clinical practice as a feasible and objectiv

关 键 词：四维左心房自动定量分析 Simpson’s法 左心房功能 左心房容积 

分 类 号：R541.4[医药卫生—心血管疾病]