CAJ | 학술논문

目的探讨经食管实时三维超声心动图(RT-3D TEE)测量冠状动脉开口与心室-动脉交界距离的可行性.方法 65例因主动脉瓣狭窄行主动脉瓣置换术患者,术中采集主动脉根部RT-3D TEE图像,利用QLAB定量分析软件,重建主动脉瓣环,生成瓣环高度参数,同时观察冠状动脉开口位置,并分别测量左、右冠状动脉开口与心室-动脉交界的距离(L-AA、R-AA).结果 65例患者中49例可较清晰地显示双侧冠状动脉开口；其余16例患者中,6例可显示右冠状动脉开口,3例仅显示左冠状动脉开口.右冠状动脉显示率为84.61％ (55/65),左冠状动脉显示率为81.54％(52/65).L-AA收缩期和舒张期均值分别为(15.5±1.9)mm、(12.8±1.5)mm,R-AA收缩期和舒张期均值分别为(13.7± 1.8)mm、(12.4±1.7) mm,二者收缩期及舒张期测值间差异均有统计学意义,其收缩期测值大于舒张期.通过RT-3D TEE重建主动脉瓣环,其自动生成的收缩期和舒张期主动脉瓣环高度均值分别为(9.5±1.0) mm、(9.4±0.9)mm,二者均低于同时相心室-动脉交界与冠状动脉开口距离.结论 RT-3D TEE及瓣环定量分析软件不仅能重建主动脉瓣环三维形态,还可显示并测量心室-动脉交界与冠状动脉开口距离.
목적 탐토경식관실시삼유초성심동도(RT-3D TEE)측량관상동맥개구여심실-동맥교계거리적가행성.방법 65례인주동맥판협착행주동맥판치환술환자,술중채집주동맥근부RT-3D TEE도상,이용QLAB정량분석연건,중건주동맥판배,생성판배고도삼수,동시관찰관상동맥개구위치,병분별측량좌、우관상동맥개구여심실-동맥교계적거리(L-AA、R-AA).결과 65례환자중49례가교청석지현시쌍측관상동맥개구；기여16례환자중,6례가현시우관상동맥개구,3례부현시좌관상동맥개구.우관상동맥현시솔위84.61％ (55/65),좌관상동맥현시솔위81.54％(52/65).L-AA수축기화서장기균치분별위(15.5±1.9)mm、(12.8±1.5)mm,R-AA수축기화서장기균치분별위(13.7± 1.8)mm、(12.4±1.7) mm,이자수축기급서장기측치간차이균유통계학의의,기수축기측치대우서장기.통과RT-3D TEE중건주동맥판배,기자동생성적수축기화서장기주동맥판배고도균치분별위(9.5±1.0) mm、(9.4±0.9)mm,이자균저우동시상심실-동맥교계여관상동맥개구거리.결론 RT-3D TEE급판배정량분석연건불부능중건주동맥판배삼유형태,환가현시병측량심실-동맥교계여관상동맥개구거리.
Objective To study the the feasibility of real-time 3D transesophageal echocardiography (RT-3D TEE) to measure the distance between the coronary ostial and the junction of left ventricle and artery.Methods The RT-3D TEE image of the aortic root was collected intraoperative in 65 cases who were refered to our center for valve replacement.The reconstruction of the aortic annulus was done in the QLAB quantitative analysis software and the height parameter of the annulus could be generated.Meanwhile the coronary artery position was observed and the distance between the coronary ostial and the junction of left ventricle and artery was measured respectively.Results In the 65 cases,49 cases clearly showed bilateral coronary ostial,three cases only showed the left coronary ostial,six cases only showed the right coronary ostial,seven cases of both sides of the coronary ostial were unclear.The shows rate of right coronary ostial was 84.61％ (55/65),with the left coronary ostial 81.54％ (52/65).The measured value of the L-AA in systole and diastole were (15.5 ± 1.9)mm,(12.8 ± 1.5)mm,the R-AA systole and diastole measured values were (13.7 ± 1.8)mm,(12.4 ± 1.7)mm,respectively,there was significant difference between systole and diastole respectively.The aortic annulus height (H) got by 3D reconstruction of the aortic annulus was lower than ventricular-arterial junction to the coronary artery distance in both systole and diastole.Conclusions Not only can RT-3D TEE reconstruct the annulus,but also can show and measure the distance between the coronary ostial and the junction of left ventricle and artery respectively.