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·臨床研究·
作者單位:200032 上海,復(fù)旦大學(xué)醫(yī)學(xué)院附屬中山醫(yī)院心內(nèi)科,上海市心血管病研究所
經(jīng)胸三維超聲心動(dòng)圖評(píng)價(jià)左室收縮功能
方法的初步研究
劉詩珍 潘翠珍 舒先紅 程蕾蕾 沈?qū)W東
【摘要】 目的 探討采用磁場(chǎng)定位系統(tǒng)經(jīng)胸三維超聲心動(dòng)圖(3DE)測(cè)定左室收縮功能的方法及可行性。方
法 健康志愿者 17 例。利用磁場(chǎng)發(fā)射及接收裝置通過手動(dòng)控制探頭在心尖區(qū)扇形掃描進(jìn)行三維數(shù)據(jù)采集。每
例受檢者均分別采集 60、 30 及 10 幅圖像(3D60、 3D30、 3D10 )各自進(jìn)行三維重建。同時(shí)記錄采集時(shí)間。采用圓盤
總和法(disk summation)測(cè)定左室舒張末期容積(LVEDV)和左室收縮末期容積(LVESV) ,得出每搏輸出量(SV)
及左室射血分?jǐn)?shù)(LVEF) 。同時(shí)用常規(guī)二維 Simpson法測(cè)量LVEF。結(jié)果 ①3D10重建后的左室短軸圖像不完
整 ,左室壁有不規(guī)則中斷 ,心腔內(nèi)結(jié)構(gòu)難以評(píng)價(jià)。3D60及 3D30重建后的左室短軸圖像完整 ,內(nèi)膜、二尖瓣及瓣下
結(jié)構(gòu)清晰可辨。②二維超聲心動(dòng)圖(2DE)測(cè)得LVEF為 0. 62 ±0. 06 ,與 3D60及 3D30的測(cè)值顯著相關(guān)( r 值分別
為 0. 87 ,0. 83 , P < 0. 001) 。③3D60測(cè)定的 EDV ,ESV ,SV 及 EF分別為(88. 11 ±18. 08) ml、 (38. 01 ±9. 23) ml、(50. 09±13. 30) ml 和 0. 57 ± 0. 07 ;3D30測(cè)定的 EDV ,ESV ,SV 及 EF 分別為(87. 51 ±15. 58) ml、 (37. 18 ±9. 62)
ml、 (50. 33 ±11. 48) ml 和 0. 58 ±0. 08 ;二者間各項(xiàng)測(cè)值差異無顯著性意義( P均 > 0. 1) ,且顯著相關(guān)( r 值分別
為 0. 94 ,0. 88 ,0. 88 ,0. 87 , P均 < 0. 001) 。④3D60的采集時(shí)間為(152. 55 ±53. 27) s ,3D30的采集時(shí)間為(72. 82 ±
17. 16) s ,比 3D60的時(shí)間節(jié)省 48 %。結(jié)論 磁場(chǎng)定位系統(tǒng)扇形掃描經(jīng)胸 3DE測(cè)定正常人左室收縮功能是準(zhǔn)確可
行的。采集 30 幅圖像與采集 60 幅圖像得到的左室收縮功能指標(biāo)無顯著差異 ,前者可縮短約一半的檢查時(shí)間 ,更加迅速方便 ,有利于臨床應(yīng)用。
【關(guān)鍵詞】 超聲心動(dòng)描記術(shù) ,三維;心室功能 ,左
Asse ssment of left ventricular function by transthoracic three dimensional echocardiography L IU S hiz hen , PA N
Cuiz hen , S HU Xianhong , et al . Department of cardiology , S hanghai Institute of Cardiovascular Diseases ,Zhongshan Hospital , Medical College of Fudan University . S hanghai 200032 , China
【Abstract】 Objective To investigate the feasibility and best method in the assessment of left vent ricular (LV)
function with t ransthoracic three 2dimensional echocardiography(3DE) .Methods Transthoracic 3DE LV data sets were
acquired in 17 normal subjects using 60 , 30 and 10 slices (3D60、 3D30、 3D10 ) respectively with a magnetic t racking
system and f reehand device. The LV end 2diastolic volume (LVEDV) and end2systolic volume (LVESV) were
measured f rom each 3DE data set with the“summation of disks”method , and st roke volume (SV) and ejection f raction
(LVEF) was derived f rom those. LVEF f rom 2DE using Simpson method was also measured. Re sults ① The
reconst ruction image of 3D10 was incomplete with many irregular interruptions in the LV wall . The images of 3D60 and
3D30 were clear , and cardiac st ructures could be well defined. ②LVEF f rom 2DE was 0. 62 ±0. 06 , which showed
excellent correlation with LVEF f rom 3D60 and 3D30 ( r = 0. 87 and 0. 83 , respectively , P < 0. 001) . ③ No
significant differences ( P > 0. 1 , respectively) , but excellent correlation in EDV , ESV , SV and EF were found
between 3D60 and 3D30 . ④ The 3D30 acquisition time was (72. 82 ±17. 16) s , which was 48 % less than the 3D60
acquisition time (152. 55 ±53. 27) s. Conclusions It is feasible to assess LV function by t ransthoracic 3DE with a
magnetic t racking system and f reehand device. Since 3D30 has the same accurate results as 3D60 and can save half of the
acquisition time. It is more suitable for clinical use.
【Key words】 Echocardiography ,three2dimensional ;Vent ricular function ,left
準(zhǔn)確測(cè)定心臟患者的左室容量和功能對(duì)于臨床治
療和預(yù)后判定是十分重要的。三維超聲心動(dòng)圖( three2
dimensional echocardiography , 3DE) 由于能再現(xiàn)左室
的空間形態(tài) ,理論上在定量評(píng)價(jià)左室功能方面具有很
大的實(shí)用性。磁場(chǎng)定位系統(tǒng)經(jīng)胸三維超聲心動(dòng)圖采用
手動(dòng)控制探頭的方法(f reehand device , FHD) ,應(yīng)用常
規(guī)經(jīng)胸探頭 ,通過磁場(chǎng)發(fā)射器 ,接收器進(jìn)行三維重建。
關(guān)于這一方法的臨床應(yīng)用研究在國(guó)內(nèi)外均處于起步階
段[1 ]。本研究擬探討應(yīng)用該技術(shù)測(cè)定左室收縮功能
的方法及可行性。
· 96 · 中華超聲影像學(xué)雜志2001 年2 月第10 卷第2 期 Chin J Ult rasonogr ,February 2001 ,Vol 10 ,No. 2
? 1995-2005 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved.資 料 與 方 法
一、研究對(duì)象
17 例健康志愿者 ,男 6 例 ,女 11 例 ,年齡 12～64
歲 ,平均(43. 4 ± 17. 3)歲 ......
作者單位:200032 上海,復(fù)旦大學(xué)醫(yī)學(xué)院附屬中山醫(yī)院心內(nèi)科,上海市心血管病研究所
經(jīng)胸三維超聲心動(dòng)圖評(píng)價(jià)左室收縮功能
方法的初步研究
劉詩珍 潘翠珍 舒先紅 程蕾蕾 沈?qū)W東
【摘要】 目的 探討采用磁場(chǎng)定位系統(tǒng)經(jīng)胸三維超聲心動(dòng)圖(3DE)測(cè)定左室收縮功能的方法及可行性。方
法 健康志愿者 17 例。利用磁場(chǎng)發(fā)射及接收裝置通過手動(dòng)控制探頭在心尖區(qū)扇形掃描進(jìn)行三維數(shù)據(jù)采集。每
例受檢者均分別采集 60、 30 及 10 幅圖像(3D60、 3D30、 3D10 )各自進(jìn)行三維重建。同時(shí)記錄采集時(shí)間。采用圓盤
總和法(disk summation)測(cè)定左室舒張末期容積(LVEDV)和左室收縮末期容積(LVESV) ,得出每搏輸出量(SV)
及左室射血分?jǐn)?shù)(LVEF) 。同時(shí)用常規(guī)二維 Simpson法測(cè)量LVEF。結(jié)果 ①3D10重建后的左室短軸圖像不完
整 ,左室壁有不規(guī)則中斷 ,心腔內(nèi)結(jié)構(gòu)難以評(píng)價(jià)。3D60及 3D30重建后的左室短軸圖像完整 ,內(nèi)膜、二尖瓣及瓣下
結(jié)構(gòu)清晰可辨。②二維超聲心動(dòng)圖(2DE)測(cè)得LVEF為 0. 62 ±0. 06 ,與 3D60及 3D30的測(cè)值顯著相關(guān)( r 值分別
為 0. 87 ,0. 83 , P < 0. 001) 。③3D60測(cè)定的 EDV ,ESV ,SV 及 EF分別為(88. 11 ±18. 08) ml、 (38. 01 ±9. 23) ml、(50. 09±13. 30) ml 和 0. 57 ± 0. 07 ;3D30測(cè)定的 EDV ,ESV ,SV 及 EF 分別為(87. 51 ±15. 58) ml、 (37. 18 ±9. 62)
ml、 (50. 33 ±11. 48) ml 和 0. 58 ±0. 08 ;二者間各項(xiàng)測(cè)值差異無顯著性意義( P均 > 0. 1) ,且顯著相關(guān)( r 值分別
為 0. 94 ,0. 88 ,0. 88 ,0. 87 , P均 < 0. 001) 。④3D60的采集時(shí)間為(152. 55 ±53. 27) s ,3D30的采集時(shí)間為(72. 82 ±
17. 16) s ,比 3D60的時(shí)間節(jié)省 48 %。結(jié)論 磁場(chǎng)定位系統(tǒng)扇形掃描經(jīng)胸 3DE測(cè)定正常人左室收縮功能是準(zhǔn)確可
行的。采集 30 幅圖像與采集 60 幅圖像得到的左室收縮功能指標(biāo)無顯著差異 ,前者可縮短約一半的檢查時(shí)間 ,更加迅速方便 ,有利于臨床應(yīng)用。
【關(guān)鍵詞】 超聲心動(dòng)描記術(shù) ,三維;心室功能 ,左
Asse ssment of left ventricular function by transthoracic three dimensional echocardiography L IU S hiz hen , PA N
Cuiz hen , S HU Xianhong , et al . Department of cardiology , S hanghai Institute of Cardiovascular Diseases ,Zhongshan Hospital , Medical College of Fudan University . S hanghai 200032 , China
【Abstract】 Objective To investigate the feasibility and best method in the assessment of left vent ricular (LV)
function with t ransthoracic three 2dimensional echocardiography(3DE) .Methods Transthoracic 3DE LV data sets were
acquired in 17 normal subjects using 60 , 30 and 10 slices (3D60、 3D30、 3D10 ) respectively with a magnetic t racking
system and f reehand device. The LV end 2diastolic volume (LVEDV) and end2systolic volume (LVESV) were
measured f rom each 3DE data set with the“summation of disks”method , and st roke volume (SV) and ejection f raction
(LVEF) was derived f rom those. LVEF f rom 2DE using Simpson method was also measured. Re sults ① The
reconst ruction image of 3D10 was incomplete with many irregular interruptions in the LV wall . The images of 3D60 and
3D30 were clear , and cardiac st ructures could be well defined. ②LVEF f rom 2DE was 0. 62 ±0. 06 , which showed
excellent correlation with LVEF f rom 3D60 and 3D30 ( r = 0. 87 and 0. 83 , respectively , P < 0. 001) . ③ No
significant differences ( P > 0. 1 , respectively) , but excellent correlation in EDV , ESV , SV and EF were found
between 3D60 and 3D30 . ④ The 3D30 acquisition time was (72. 82 ±17. 16) s , which was 48 % less than the 3D60
acquisition time (152. 55 ±53. 27) s. Conclusions It is feasible to assess LV function by t ransthoracic 3DE with a
magnetic t racking system and f reehand device. Since 3D30 has the same accurate results as 3D60 and can save half of the
acquisition time. It is more suitable for clinical use.
【Key words】 Echocardiography ,three2dimensional ;Vent ricular function ,left
準(zhǔn)確測(cè)定心臟患者的左室容量和功能對(duì)于臨床治
療和預(yù)后判定是十分重要的。三維超聲心動(dòng)圖( three2
dimensional echocardiography , 3DE) 由于能再現(xiàn)左室
的空間形態(tài) ,理論上在定量評(píng)價(jià)左室功能方面具有很
大的實(shí)用性。磁場(chǎng)定位系統(tǒng)經(jīng)胸三維超聲心動(dòng)圖采用
手動(dòng)控制探頭的方法(f reehand device , FHD) ,應(yīng)用常
規(guī)經(jīng)胸探頭 ,通過磁場(chǎng)發(fā)射器 ,接收器進(jìn)行三維重建。
關(guān)于這一方法的臨床應(yīng)用研究在國(guó)內(nèi)外均處于起步階
段[1 ]。本研究擬探討應(yīng)用該技術(shù)測(cè)定左室收縮功能
的方法及可行性。
· 96 · 中華超聲影像學(xué)雜志2001 年2 月第10 卷第2 期 Chin J Ult rasonogr ,February 2001 ,Vol 10 ,No. 2
? 1995-2005 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved.資 料 與 方 法
一、研究對(duì)象
17 例健康志愿者 ,男 6 例 ,女 11 例 ,年齡 12～64
歲 ,平均(43. 4 ± 17. 3)歲 ......
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