二维与实时三维超声心动图对法乐氏四联症患儿右室收缩功能评价指标的相关性研究  

The Correlation Study of 2DE and RT-3DE Right Ventricular Systolic Function Index in TOF Children

作　　者：高峻[1] 谢明星[2] 赵亚平[1] 张庆[1] 何钊群[1] 李蔚[1] 彭晶[1] 孙杰[1] 

机构地区：[1]武汉市儿童医院超声科,武汉市430016 [2]华中科技大学同济医学院附属协和医院超声科

出　　处：《中国超声医学杂志》2015年第6期515-517,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨二维(2DE)与实时三维超声心动图(RT-3DE)评价法乐氏四联症(TOF)患儿右室收缩功能指标的相关性。方法选择45例TOF患儿及46例正常同龄对照组作为研究对象,获取二维右室收缩功能指标:三尖瓣环侧壁收缩期位移距离(TAPSE),三尖瓣环侧壁收缩期峰值运动速度(TRV),右室心尖四腔观面积收缩率(RVa);应用RT-3DE于心尖偏胸骨旁四腔心采集右室全容积声像图,使用TomTec RV-Function软件分析右室射血分数(RVEF);对TOF组与正常对照组2DE及RT-3DE右室收缩功能指标进行比较并进行相关性分析。结果 TOF组RT-3DE获得的RVEF与2DE各右室收缩功能指标均小于正常对照组(P<0.05)。2DE各指标与RT-3DE获得的RVEF均呈正相关性(P<0.01),其中TAPSE与RVEF的相关性最好,r=0.574,P=0.000,ROC曲线分析表明TAPSE>1.68cm时,评价RVEF>45%的灵敏度为80%,特异度为78%(P=0.000)。结论 TOF患儿右室收缩功能减低,RT-3DE使快速无创评估右室射血分数成为可能。Objective To investigate the correlation of right ventricular systolic function indexes evaluated by2DE(2Dechocardiography)and RT-3DE(real-time 3Dechocardiography)in TOF children.Methods 45 TOF children and 46 normal age-matched children were recruited in this study.2DE right ventricular systolic function indexes:tricuspid annular lateral wall peak systolic excursion(TAPSE),tricuspid annular peak systolic velocity(TRV)and right ventricular systolic area shortening(RVa).Full volume imaging of right ventricle(RV)was obtained at the parasternal four-chamber view near the apex by RT-3DE.The right ventricular ejection fraction(RVEF)was analyzed by TomTec RV-Function.2DE and RT-3DE indexes were compared between TOF and normal groups.The correlation analysis were performed between RT-3DE and 2DE indexes.Results In TOF group 2DE and RT-3DE indexes were all lower than those in normal group(P<0.05).The correlation analysis on RT-3DE and 2DE indexes demonstrated that RVEF by RT-3DE had positive correlation with all 2DE indexes(P<0.01),the best correlation was found with TAPSE:r=0.574,P=0.000.ROC curve estimation showed cut off value of TAPSE >1.68 cm yielded specificity(78%)and sensitivity(80%)to estimate RVEF>45%(P=0.000).Conclusions Right ventricular systolic function reduced in TOF children.RT-3DE made it possible for estimating right ventricular ejection fraction noninvasively and rapidly.

关 键 词：二维超声心动图 实时三维超声心动图 法乐氏四联症 右室 收缩功能 

分 类 号：R540.45[医药卫生—心血管疾病] R725.4[医药卫生—内科学]