CAJ | 학술논문

目的探讨经食管实时三维超声心动图(RT 3D-TEE)测量主动脉瓣径的可行性及准确性.方法对26例拟行经导管主动脉瓣植入术(TAVI)的患者,术前分别采用经胸二维超声心动图(TTE)、经食管二维超声心动图(TEE)、RT 3D-TEE及CT测量主动脉瓣环径.RT 3D-TEE通过切割主动脉根部,准确获得主动脉瓣环平面相关测值,包括瓣环面积换算的瓣环径、瓣环最大径、最小径,并计算偏心指数(瓣环最大径/最小径).CT对应的主动脉瓣环径包括瓣环周长换算的瓣环径、最大径、最小径及偏心指数.对比分析超声方法与CT所测的主动脉瓣环径及偏心指数.结果与CT测值相比较,TEE、RT 3D-TEE所测的主动脉瓣环径差异无统计学意义(P＜0.05),而TTE所测的主动脉瓣环径差异有统计学意义(P＞0.05).TEE与RT 3D-TEE所测的主动脉瓣环径比较差异无统计学意义(P＜0.05),而TTE与TEE、RT 3D-TEE所测的主动脉瓣环径相比差异均有统计学意义(P＞0.05),且测值偏小.所有超声测量方法中,通过RT 3D-TEE实时切割的方法所测的主动脉瓣环径与CT测值相关性最好(r =0.92,P＜0.05).RT 3D-TEE所测的主动脉瓣环偏心指数与CT测值相比差异无统计学意义(1.25±0.12 vs1.28±0.13,P＞0.05).结论 RT 3D-TEE不仅能准确测量主动脉瓣环径,而且能提供主动脉瓣环的最大径、最小径及偏心指数,为TAVI球囊型号及瓣膜型号的选择提供了可靠依据.
목적 탐토경식관실시삼유초성심동도(RT 3D-TEE)측량주동맥판경적가행성급준학성.방법 대26례의행경도관주동맥판식입술(TAVI)적환자,술전분별채용경흉이유초성심동도(TTE)、경식관이유초성심동도(TEE)、RT 3D-TEE급CT측량주동맥판배경.RT 3D-TEE통과절할주동맥근부,준학획득주동맥판배평면상관측치,포괄판배면적환산적판배경、판배최대경、최소경,병계산편심지수(판배최대경/최소경).CT대응적주동맥판배경포괄판배주장환산적판배경、최대경、최소경급편심지수.대비분석초성방법여CT소측적주동맥판배경급편심지수.결과 여CT측치상비교,TEE、RT 3D-TEE소측적주동맥판배경차이무통계학의의(P＜0.05),이TTE소측적주동맥판배경차이유통계학의의(P＞0.05).TEE여RT 3D-TEE소측적주동맥판배경비교차이무통계학의의(P＜0.05),이TTE여TEE、RT 3D-TEE소측적주동맥판배경상비차이균유통계학의의(P＞0.05),차측치편소.소유초성측량방법중,통과RT 3D-TEE실시절할적방법소측적주동맥판배경여CT측치상관성최호(r =0.92,P＜0.05).RT 3D-TEE소측적주동맥판배편심지수여CT측치상비차이무통계학의의(1.25±0.12 vs1.28±0.13,P＞0.05).결론 RT 3D-TEE불부능준학측량주동맥판배경,이차능제공주동맥판배적최대경、최소경급편심지수,위TAVI구낭형호급판막형호적선택제공료가고의거.
Objective To study the feasibility and accuracy of real-time three-dimensional transesophageal echocardiography (RT 3D-TEE) in measuring the aortic annulus dimension(AAD),and compared with CT measurements.Methods The AAD was measured by transthoracic echocardiography (TTE),transesophageal echocardiography(TEE) and RT 3D-TEE in 26 cases who were refered to our center for transcatheter aortic valve implantation(TAVI).Cross-sectional RT 3D-TEE can offer the AAD derived from the aortic annulus area,the maximal AAD,the minimal AAD and the eccentric index(the maximal AAD/the minimal AAD).The echo dimensions were compared with the CT measurements.Results No statistically significant differences were found between RT 3D-TEE and CT,and they have the best correlation(r =0.92,P ＜ 0.05).Meanwhile,There was no statistically significant difference in the eccentric index of the AAD between RT 3D-TEE and CT(1.25± 0.12 vs 1.28± 0.13,P ＞0.05).Conclusions RT-3D TEE imaging not only measure the AAD accurately,but also provide the maximal AAD,minimal AAD and the eccentric index for TAVI.