实时三维超声心动图与磁共振对比评价左心室射血分数≥45%患者的左心室容量

目的:评价实时三维超声心动图(RT3D)测量左心室射血分数(LVEF)≥45% 成年人左心室容量的准确性和重复性.方法:选取因各种不同原因进行心脏磁共振(MRI)检查显示 LVEF ≥45%的患者37例,同时进行RT3D检查.RT3D检查采用Philips iE-33型超声心动图仪,左心室容量及左心室功能的分析通过TomTec工作站用人工描记法完成,并与MRI所得结果相比较.结果:MRI测量的左心室舒张末期容量(EDV)为:60～208.76(110.48±33.50)ml,左心室收缩末期容量(ESV)为:19～102.4(45.80±17.84 )ml,LVEF为:45.40～71.10(59.13±7.24)%.RT3D测量的EDV为:42.8～ 211.9(100.64±34.48)ml,ESV为:14.30 ～94.54(44.08 ±17.62)ml,LVEF为:35.1～73.4(56.70±7.02)%.与MRI相比,RT3D低估EDV(P＜0.01,r=0.842,y=0.867x+4.88,SEE=18.86ml),二者平均相差(-9.84±38.26) ml.RT3D同时低估ESV,二者相比差异无统计学意义(P＞0.05,r=0.846,y=0.835x+5.82,SEE=9.53 ml),二者平均相差(-1.71±19.68)ml.RT3D所测的LVEF稍小于MRI所测得的LVEF,二者相比差异有统计学意义(P＜0.05,r=0.616,y=0.597x+21.38,SEE=5.61%),平均相差(-2.42±12.5 )%.在不同观察者间及观察者自身不同时间内测量的RT3D,结果显示良好的重复性.结论:与MRI相比,RT3D测量成人患者的左心室容量及LVEF有较好的准确性和重复性.

Comparison of real-time three-dimensional echocardiography to magnetic resonance imaging for assessment of the left ventricle volumes in patients whose left ventricle ejection fraction more than 45%

Objective:The purpose of this study was to assess the left ventricle (LV) volumes and function acquired by real-time(RT) three-dimensional echocardiography (3D) in adult patients whose LV ejection fraction (LVEF) more than 45%, compared with magnetic resonance imaging (MRI) data. Methods:Unselected patients (n=37; 22 men; age, 57.78±17.23 years) with various cardiovascular disease were evaluated on the same day by MRI and RT3D. RT3D was performed with a Philips iE-33 echocardiographic system and LV volumes and function analyses with the assistance of TomTec software. The results for LV volumes and function obtained by manual tracing were compared with Signa 1.5-T MRI data.Results:The average MRI EDV was 110.48±33.50ml (60-208.76ml),ESV was 45.80±17.84 ml(19-102.4ml),EF was 59.13±7.24% (45.40-71.10%). The average RT3D EDV was 100.64±34.48ml (42.8- 211.9ml),ESV was 44.08 ±17.62ml (14.30 - 94.54ml),EF was 56.70±7.02% (35.1-73.4%). Compared with MRI values, EDV was underestimated by 3D (P＜0.01,r=0.842,y=0.867x+4.88,SEE=18.86 ml), with a mean difference of (-9.84±38.26) ml; ESV was also underestimated by 3D (P＞0.05,r=0.846,y=0.835x+5.82,SEE=9.53 ml) with a mean difference of( -1.71±19.68)ml. Ejection fraction by MRI was larger than that by 3D (P＜0.05,r=0.616,y=0.597x+21.38,SEE=5.61%), with a mean difference of (-2.42±12.5) %. There was good inter-and intra-observer correlation between RT-3D by two sonographers for volumes and ejection fraction.Conclutsions:The assessment of LV volume and ejection fraction from RT-3D data is feasible in patients . The volume and ejection fraction can be determined with high accuracy and low interobserver variability in patients with adequate echocardiographic image quality.