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目的探讨实时三维超声心动图(RT-3DE)测量二尖瓣狭窄瓣口面积的准确性。方法20例拟行外科瓣膜置换的风湿性二尖瓣狭窄患者,术前利用二维超声、多普勒超声和RT-3DE三种方法测量二尖瓣口舒张期最大开放面积(MVA),获取二维超声心动图法测值(MVA2DE)、多普勒压差降半时间法测值(MVAPHT)及RT-3DE测值(MVART-3DE)。于二尖瓣置换术中留取完整的狭窄二尖瓣口标本,用RT-3DE及照相法分别测其瓣口面积,(MVAOP3DE和MVAOP)。MVAOP与前述超声方法测值进行比较。结果①MVAOP与MVAOP3DE、MVART-3DE、MVA2DE、MVAPHT的相关性分别为r=0.94、r=0.89、r=0.84及r=0.78;②MVAOP与MVAOP3DE之间差异无统计学意义(P>0.05),与MVART-3DE、MVA2DE、MVAPHT之间差异均有统计学意义(P<0.05);③MVART-3DE、MVA2DE、MVAPHT之间差异均无统计学意义(P>0.05);④Bland-Altman分析图显示MVAOP3DE、MVART-3DE均与MVAOP有良好的一致性。结论RT-3DE能够简便、准确、可靠地定量评价二尖瓣狭窄病变。
Objective To investigate the accuracy of real-time three-dimensional echocardiography (RT-3DE) in measuring mitral valve stenosis. Methods Twenty patients with rheumatic mitral stenosis who underwent surgical valve replacement were enrolled in this study. The maximum open area (MVA) of mitral valve was measured by two-dimensional ultrasound, Doppler ultrasound and RT-3DE before operation. Two-dimensional echocardiography (MVA2DE), Doppler pressure drop half-time method (MVAPHT) and RT-3DE measurement (MVART-3DE). The intact stenotic mitral valve specimens were collected during mitral valve replacement. The flap area was measured by RT-3DE and photographic method (MVAOP3DE and MVAOP). MVAOP with the aforementioned ultrasonic method to compare the measured values. Results ① The correlation between MVAOP and MVAOP3DE, MVART-3DE, MVA2DE and MVAPHT were r = 0.94, r = 0.89, r = 0.84 and r = 0.78 respectively; ② There was no significant difference between MVAOP and MVAOP3DE (P> 0.05) There was no significant difference between MVART-3DE, MVA2DE and MVAPHT (P> 0.05); ④Bland-Altman analysis showed that MVAOP3DE, MVART-3DE is in good agreement with MVAOP. Conclusion RT-3DE can be used to evaluate mitral stenosis easily, accurately and reliably.