【摘要】 目的：体元模型动态三维重建技术的发展为我们定量心脏结构的病理变化提供了方便。本研究旨在评价该技术定量二尖瓣狭窄患者二尖瓣体积的准确性以及定量二尖瓣体积潜在的临床应用价值。研究对象为从１２例二尖瓣换瓣术后获得的离体二尖瓣标本，３６例二尖瓣狭窄患者（年龄４７±９６岁）和１０例正常人（年龄４３７±８４岁）。图像采集采用美国ＨｅｗｌｅｔＰａｃｋａｒｄＳｏｎｏｓ２５００超声诊断仪和５ＭＨｚ多平面经食管超声探头。三维重建采用德国ＴｏｍＴｅｃＥｃｈｏｓｃａｎ计算机工作站。采用三维提取法将二尖瓣单独提取分析其体积。结果：所有研究对象均获得满意的三维重建。三维重建测定的离体二尖瓣体积为４９５±１５２ｍｌ，实测值为４９０±１５７ｍｌ，二者差别无显著意义（Ｐ＞００５），并且高度相关（ｒ＝０９８，Ｐ＜００００５）。三维重建测定的二尖瓣狭窄患者二尖瓣膜的体积大于正常人，分别为９０±２２ｍｌ和４５±０７ｍｌ，差别有显著意义（Ｐ＜０００１）。结论：体元模型动态三维重建能够准确地定量二尖瓣体积，二尖瓣狭窄者的二尖瓣体积大于正常人，本研究为今后二尖瓣球囊扩张术前病例的选择提供了客观依据。更多还原

【Abstract】 OBJECTIVE:Quantitative three-dimensional echocardiography provides accurate measurement of heart structures.The objective of this study is to measure mitral valve volumes(MVV) in patients with mitral valve stenosis and preliminary evaluation of its clinical application. METHODS:Quantitative three-dimensional echocardiography(3D-Echo)was used for the MVV measurement of 12 operatively excised MV specimens,10 normal subjects (mean age 437±84years)and 36 rheumatic mitral valve stenosis(MS)patients(mean age 47±96years).HP Sonos 2500 echocardiographic system and 5MHz multiplane transesophageal echocardiography were used for data acquisition and Tom Tec Echoscan computer system was used for the three dimensional reconstruction and quantitative analysis.RESULTS:In-vitro MV specimen volumes measured by 3D-Echo excellantely correlated with real volumes(495±152ml and 49±157ml,r=098,P<00005)In all MS patients MVV was greater than normal subjects(90±22ml and 45±07ml,P<0001).CONCLUSIONS:Quantitative three-dimensional echocardiography accurately measures mitral valve volumes in-vivo. Mitral valve volume is greater in MS patients than normal subjects.In future,it may be used as one of the quantitative criteria for the selection of percutaneous ballon mitral valvotomy patients and other therapeutic options.更多还原