南方医科大学学报

南方医科大学学报 ›› 2021, Vol. 41 ›› Issue (2): 238-242.doi: 10.12122/j.issn.1673-4254.2021.02.11

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经食管二维和三维超声心动图测量计算人工二尖瓣有效瓣口面积的一致性

周 磊, 魏海燕, 葛亚力, 丁正年, 史宏伟   

  • 发布日期:2021-02-05

Consistency of effective orifice area of prosthetic mitral valve estimated using 2-dimensional and 3-dimensional transesophageal echocardiography

  • Published:2021-02-05

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摘要：

目的 分析经食管超声心动图（TEE）二维和三维两种方法测量计算人工二尖瓣有效瓣口面积的一致性。方法 选择2019年3~6月在南京市第一医院择期行单纯二尖瓣置换术的 34例患者为研究对象，在瓣膜置换结束后采用二维TEE测量左心室流出道直径，计算左室流出道横截面积，同时采用三维TEE，通过3D几何量化软件直接描记测量左室流出道横截面积。使用平衡方程法，分别计算所置换人工二尖瓣的有效瓣口面积（EOA），采用 Bland-Altman PLOT一致性检验分析两组结果EOA-2D和EOA-3D的一致性，并采用线性回归分析两者的相关性。结果 二维和三维法测量共 34对 EOA 值，两种方法测量结果为（2.22±0.71 cm2 vs 2.35±0.70 cm2，n=34，P<0.001），差值均数为（-0.14±0.20 cm2 ），95%一致性界限为（-0.53，0.25 cm2 ）；EOA-3D和EOA-2D的回归方程为y=0.27+0.94×x，相关程度较好。结论 TEE二维和三维描记两种方法测量计算人工二尖瓣有效瓣口面积的一致性较好，二维法测量结果略低于三维法约6%。

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Abstract:

Objective To analyze the consistency of effective orifice area (EOA) of prosthetic mitral valve estimated using 2-dimensional (2D) and 3-dimensional (3D) transesophageal echocardiography (TEE). Methods This study was conducted among 34 patients undergoing mitral valve replacement surgery in Nanjing First Hospital between March and June in 2019. The diameter of the left ventricular outflow tract (LVOT) measured by 2D-TEE was used to calculate the cross sectional area of LVOT (CSALVOT). In 3D-TEE method, LVOT area was measured directly by planimetry on an enface view. The EOAs of the prosthetic mitral valve were calculated for both methods using the continuity equation. Bland-Altman plot consistency test was used to analyze the consistency between the two sets of EOA results, and linear regression analysis was used to analyze their correlation. Results The EOA of the prosthetic mitral valve differed significantly between 2D method and 3D method (2.22±0.71 cm2 vs 2.35±0.70 cm2, P<0.001) with a mean difference of -0.14±0.20 cm2 and 95% coherence boundaries of (-0.53, 0.25 cm2 ). The regression equation for EOA-3D and EOA-2D is y=0.27 + 0.94x, showing a good correlation between the two methods. Conclusion EOA estimation of the prosthetic mitral valve using 2D and 3D TEE has a good consistency, and the results estimated by the 2D method are slightly lower by about 6% than those by the 3D method.

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