| 摘要: |
| 目的 探讨经胸超声心动图二维及三维增强成像技术评估犬左室结构及功能的准确性及可重复性。方法 采集12只比格犬左室长轴切面腱索水平M型图像和非增强及增强模式下以左心为主的心尖四腔、三腔、两腔切面及三维全容积图像。分别判断二维超声心动图(2DE)及三维超声心动图(3DE)非增强及增强模式下左室心尖四腔、三腔、两腔及整体心内膜显示的节段数,并测量2DE非增强及增强模式下左室舒张末期长径(LVLD)。分别采用M型Teichholz公式、非增强及增强模式下双平面Simpson法测量左室舒张末期容积(left ventricular end diastolic volume,LVEDV)、左室收缩末期容积(left ventricular end systolic volume,LVESV)、左室射血分数(left ventricular ejection fraction,LVEF)。采用TomTec软件对左室三维全容积图像进行后处理分析,分别测量3DE非增强及增强模式下的LVEDV、LVESV、LVEF。以解剖标本测值为金标准进行对照分析,评价不同方法测量LVLD、LVEDV的准确性。同一观察者及不同观察者对所有指标再次测量,评价不同方法测量不同指标的可重复性。结果 增强模式2DE及3DE对左室壁节段心内膜显示率较非增强模式明显增加,以增强模式2DE最佳(均P<0.05)。增强模式下2DE所测LVLD与解剖标本长径测值相关性较非增强模式更高(0.851对0.748)。M型、非增强及增强模式下2DE及3DE测量LVEDV值与解剖标本测值的相关性分别为0.612、0.806、0.857、0.728、0.869(均P<0.05),增强模式下测值准确性更高,以增强模式3DE最高。增强模式2DE及3DE测量LVEDV、LVESV、LVEF的可重复性高于M型及非增强模式,其变异系数更小,以增强模式3DE最小。结论 经胸超声心动图增强成像技术可以改善2DE及3DE图像质量,提高左室结构及功能相关参数测量的准确性及可重复性,为临床上精确评估及动态监测左室结构及功能提供了新方法。 |
| 关键词: 超声心动图描记术 心室功能，左 超声增强剂 |
| DOI： |
| 投稿时间：2019-12-17修订日期：2020-01-02 |
| 基金项目: |
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| Evaluation of left ventricular structure and function by two- and three-dimensional contrast-enhanced transthoracic echocardiography: a experimental study |
| ZHOU Yanxiang,ZHOU Qing,XIONG Ye,SONG Wanwan,YANG Yuanting,YI Renfeng,CAO Sheng,GUO Ruiqiang |
| (Department of Ultrasonography,Renmin Hospital of Wuhan University) |
| Abstract: |
| ABSTRACT Objective To discuss the accuracy and repeatability of left ventricular structural and functional measurements by two- and three-dimensional contrast-enhanced transthoracic echocardiography (2D cTTE and 3D cTTE). Methods M-mode in parasternal long-axis views were obtained from 12 beagles, and the apical four-chamber, three-chamber and two-chamber views and the three-dimensional full-volume images of the left ventricle were collected with unenhanced and contrast-enhanced transthoracic echocardiography. The intimal display rates in apical four-chamber, three-chamber and two-chamber views of the left ventricular segment were evaluated by two- and three- dimensional unenhanced echocardiography (2D TTE and 3D TTE), 2D cTTE and 3D cTTE. Left ventricular end diastolic longitudinal dimension (LVLD) was measured with 2D TTE and 2D cTTE. Left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured respectively with Teichholz method of M mode, biplane Simpson method of 2D TTE and 2D cTTE. Left ventricular three-dimensional full-volume images were processed and analyzed by TomTec software, LVEDV, LVESV, LVEF were measured respectively with 3D TTE and 3D cTTE. The measurements of pathological specimen were taken as the gold standard, the accuracies of measuring LVLD and LVEDV by different methods were evaluated. All indexes were measured again by the same observer and different observers, and the reproducibility of different methods for measuring different indexes was evaluated. Results ①The intimal display rate of the left ventricular segment was higher with 2D cTTE and 3D cTTE than that with 2D TTE and 3D TTE, 2D cTTE was the best (P<0.05). ②The measurements of LVLD by 2D cTTE were more relevent with the measurements by pathological specimen than that by 2D TTE. (0.851 vs. 0.748). The measurements of LVEDV by M mode, 2D TTE, 2D cTTE, 3D TTE and 3D cTTE correlated with the measurements by pathological specimen (0.612、0.806、0.857、0.728、0.869, respectively). 2D cTTE and 3D cTTE can provide more accurate measurements, 3D cTTE was the most precise method. ③For inter- and intraobservers, the coefficient of variation of LVEDV, LVESV, LVEF with 2D cTTE and 3D cTTE were lower than that with M mode, 2DTTE, 3DTTE. Conclusions Contrast-enhanced transthoracic echocardiography can improve image quality of 2D TTE and 3D TTE with more accurate and repeatable measurements, providing a new method for clinical precise evaluation and dynamic monitoring of left ventricular structure and function. |
| Key words: Echocardiography Ventricular function, left Ultrasound enhancing agents |
