CAJ | 학술논문

目的：用经胸实时三维超声心动图技术（RT-3DE）评估正常人右室整体及节段收缩功能；并与左室三维及传统方法相比较，评价三维测量右室每搏输出量（RVSV）的准确性。方法34例正常成人，行经胸左、右心室RT-3DE图像采集，脱机分析右室整体及流出道（RV-outflow）、体部（RV-body）和流入道（RV-inflow）节段容积参数和射血分数（RVEF），左室整体三维容积参数和射血分数（LVEF）。同时用传统M型Teichholtz方法测量LVSV和LVEF；用右室流出道流速曲线速度时间积分（VTI）方法估测RVSV。分析3种方法测得SV的相关性。结果34例正常人三维方法测得的RVSV 与三维方法测得的LVSV相关性较高（r=0.86，P<0.001）；与Teichholtz方法测得的LVSV相关性较差（r=0.31，P<0.001）；与右室流出道VTI方法测得的RVSV相关性较差（r=0.46，P<0.001）；二维和流速曲线方法测值均较三维方法偏高（P<0.05）。右室各节段收缩强度存在差异，节段EF值（%）流入道（62.00±7.20)＞流出道（53.08±14.10）＞体部（32.00±11.08）（P<0.05）。右室三维整体收缩功能参数经体表面积标化后，不同性别间未见显著统计学差异。结论RV-3DE方法评估正常成人LVSV、RVSV一致性好，相关性较高。正常人右室流入道的收缩活动强度及对整体每搏输出量的贡献占主要地位，其次是流出道、体部。RT-3DE为研究右室整体和节段收缩功能提供了可靠、无创的新方法。
목적：용경흉실시삼유초성심동도기술（RT-3DE）평고정상인우실정체급절단수축공능；병여좌실삼유급전통방법상비교，평개삼유측량우실매박수출량（RVSV）적준학성。방법34례정상성인，행경흉좌、우심실RT-3DE도상채집，탈궤분석우실정체급류출도（RV-outflow）、체부（RV-body）화류입도（RV-inflow）절단용적삼수화사혈분수（RVEF），좌실정체삼유용적삼수화사혈분수（LVEF）。동시용전통M형Teichholtz방법측량LVSV화LVEF；용우실류출도류속곡선속도시간적분（VTI）방법고측RVSV。분석3충방법측득SV적상관성。결과34례정상인삼유방법측득적RVSV 여삼유방법측득적LVSV상관성교고（r=0.86，P<0.001）；여Teichholtz방법측득적LVSV상관성교차（r=0.31，P<0.001）；여우실류출도VTI방법측득적RVSV상관성교차（r=0.46，P<0.001）；이유화류속곡선방법측치균교삼유방법편고（P<0.05）。우실각절단수축강도존재차이，절단EF치（%）류입도（62.00±7.20)＞류출도（53.08±14.10）＞체부（32.00±11.08）（P<0.05）。우실삼유정체수축공능삼수경체표면적표화후，불동성별간미견현저통계학차이。결론RV-3DE방법평고정상성인LVSV、RVSV일치성호，상관성교고。정상인우실류입도적수축활동강도급대정체매박수출량적공헌점주요지위，기차시류출도、체부。RT-3DE위연구우실정체화절단수축공능제공료가고、무창적신방법。
Objective To assess the global and segmental systolic functions of the right ventricle (RV) in normal adults by real-time three-dimensional echocardiography (RT-3DE), and to assess the accuracy in estimation of the right ventricle stroke volume (RVSV). Methods Thirty-four normal adults underwent conventional two-dimensional echocardiography and RT-3DE of the left ventricle (LV) and right ventricle (RV). Off-line analysis of right ventricular end-diastolic volume (RVEDV), left ventricular end-systolic volume (RVESV), RVSV and right ventricular ejection fraction (RVEF) of global and regional RV including outflow tract (RV-outflow ), body (RV-body) and inflow tract (RV-inflow), as well as LV global three-dimensional volume data (LVEDV, LVESV and LVSV ) and ejection fraction (LVEF) was conducted. Meanwhile, LV volume parameters were measured using M-mode Teichholtz method. The RVSV was estimated using RV outflow tract velocity-time integral (VTI) method. Comparative analysis was performed on the correlation among measurement results using different methods above. Results A high correlation was presented between three-dimensional measurement of RVSV and three-dimensional measurement of LVSV in 34 normal adults (r=0.86, P<0.001); A poor correlation was found between RVSV measured by three-dimensional method and LVSV measured by M-mode method (LVSV-M) (r=0.31, P<0.001); And a poor correlation was found between RVSV measured by three-dimensional method and that measured by RV outflow tract VTI method (r=0.46, P<0.001). Segmental ejection fraction(%) were sorted from high to low as follow RVEF-inflow(62.00±87.20)>RVEF-outflow(53.08± 14.10)> RVEF-body(32.00±11.08). No statistically significant differences were found in RV global three-dimensional volume parameters between males and females after the standardization of body surface area (P>0.05). Conclusion The application of RT-3DE provides a reliable innovative method for the evaluation of RV global and segmental systolic functions.