CAJ | 학술논문

目的运用经食管实时三维超声心动图(RT-3D-TEE)探讨在主动脉瓣交界平面测量主动脉瓣环径(AAD)的可行性与准确性.方法 23例因获得性主动脉瓣病变而行主动脉瓣置换术患者,术前经胸超声心动图(TTE)在胸骨旁左室长轴观测量AAD(TTE-AAD);术中开胸前应用RT-3D-TEE在左室长轴观测量AAD以及对主动脉瓣进行二维及三维成像并在大动脉短轴观测量三个瓣叶交界点间的距离(N、L、R),三维全容积图像运用QLAB 7.0软件进行在线分析;术中用标准圆柱形测瓣器测量AAD(OP-AAD).结果获得性主动脉瓣病变无论性质及程度如何,经食管超声心动图(TEE)显示三个瓣叶交界点连线近似等边三角型,三者差异无统计学意义(P>0.05);TTE-AAD与OP-AAD比较,差异无统计学意义(P>0.05),相关性较好(r=0.84);N、L和R分别与OP-AAD值比较,差异无统计学意义(P>0.05),相关性优于TTE-AAD(r=0.94,0.97,0.96);术中经食管左室长轴观测量AVD(TEE-AAD)与OP-AAD差异有统计学意义(P<0.05).结论在大动脉短轴主动脉瓣三个瓣叶交界点平面测量AAD是可行的,与胸骨旁左室长轴观相比较具有更好的准确性及可重复性.
목적 운용경식관실시삼유초성심동도(RT-3D-TEE)탐토재주동맥판교계평면측량주동맥판배경(AAD)적가행성여준학성.방법 23례인획득성주동맥판병변이행주동맥판치환술환자,술전경흉초성심동도(TTE)재흉골방좌실장축관측량AAD(TTE-AAD);술중개흉전응용RT-3D-TEE재좌실장축관측량AAD이급대주동맥판진행이유급삼유성상병재대동맥단축관측량삼개판협교계점간적거리(N、L、R),삼유전용적도상운용QLAB 7.0연건진행재선분석;술중용표준원주형측판기측량AAD(OP-AAD).결과 획득성주동맥판병변무론성질급정도여하,경식관초성심동도(TEE)현시삼개판협교계점련선근사등변삼각형,삼자차이무통계학의의(P>0.05);TTE-AAD여OP-AAD비교,차이무통계학의의(P>0.05),상관성교호(r=0.84);N、L화R분별여OP-AAD치비교,차이무통계학의의(P>0.05),상관성우우TTE-AAD(r=0.94,0.97,0.96);술중경식관좌실장축관측량AVD(TEE-AAD)여OP-AAD차이유통계학의의(P<0.05).결론 재대동맥단축주동맥판삼개판협교계점평면측량AAD시가행적,여흉골방좌실장축관상비교구유경호적준학성급가중복성.
Objective To research the feasibility and accuracy on echocardiography measurement aortic annulus diameter(AAD)at the plane of three Junctions of aortic valve leaflets by real-time three-dimensional transesophageal echocardiography(RT-3D-TEE).Methods Twenty-three patients underwent echocardiography and aortic valve replacement because of acquired aortic valve disease.The AAD was measured in parasternal left ventricle long axis view(TTE-AAD)by transthoracic echocardiography(TTE)preoperative.The AAD was measured in left ventricle long axis view(TEE-AAD)and the distance of three iunctions of aortic valve leaflets (N,L,R) was measured in aortic short axis view by RT-3D-TEE intraoperative.The three-dimensional full volume images were analyzed by online QLAB 7.0 software.The AAD was measured by standard cylindrical valve sizer (OP-AAD)before aortic valve replacement surgery,too.Results Comparing with the three aortic valve leaflets of acquired aortic valve disease,the lines between their junctions constituted an approximate equilateral triangle regardless of the cause and degree of disease,and the length of the three groups was no significant difference(P>0.05).There was no significant difference between TTE-AAD and OP-AAD group(P>0.05),and the correlation was good(r=0.84).The N,L and R group compared separately with the OP-AAD group, there was no significant difference(P>0.05)and correlation was superior to TTE-AAD group(r=0.94, 0.97, 0.96).The difference between TEE-AAD and OP-AAD were significant(P<0.01).Conclusions Echocardiography measurement of AAD at the plane of three junctions of aortic valve leaflets is feasible,and it is better accuracy and repeatability comparing with parasternal left ventricle long axis view.