【摘要】 目的运用MVA软件结合三维成像技术对缺血性二尖瓣反流(IMR)和非缺血性MR患者的二尖瓣瓣环瓣膜进行定量评价,初步探讨MVA的临床应用。方法患者分为3组:IMR组(10例)和非缺血性MR组(7例),无二尖瓣异常及反流者为对照组(11例)。采用经食管二尖瓣及瓣环的三维图像采集和重建,将三维图像与手术结果进行对比。用Siemens MVA软件进行定量分析,测量参数包括二尖瓣环三维前后径(AP径)、三维交界径(CC径)、三维前外-后内径(AL-PM径)、非平面角度(NPA)、前瓣环长度、后瓣环长度、三维瓣环周长、瓣环面积(MAA)等,并用体表面积校正。计算上述参数在心动周期的变化值(舒张末-收缩末)。结果与对照组相比,IMR组瓣环空间成角NPA增大,瓣环趋于平面化(P<0.01);二尖瓣后瓣环较对照组明显扩大(P<0.05),收缩期扩张(中位Δ后瓣环长度:-2.71mm/m2vs0.52mm/m2,P<0.05)。对非缺血性MR组,MVA软件能精确显示二尖瓣病变的部位、范围及机制,与手术结果一致。结论MVA软件可精确地显示二尖瓣的几何形态及关闭不全的部位和范围,可定量评价瓣环的空间构型及其动态变化,有助于指导临床治疗。更多还原

【Abstract】 Objective To evaluate the geometry of mitral valve and annulus in patients with mitral regurgitation,and to quantify the mitral annular remodeling and motion in ischemic mitral regurgitation(IMR) with mitral valve assessment(MVA) software.Methods Seventeen patients were divided into two groups:IMR group(n=10) and non-IMR group(n=7),and other 11 patients without significant mitral regurgitation(<2+) and mitral structure abnormality were regarded as control group.The imaging was analyzed offline with Siemens MVA software to measure the annular diameters,annular circumference,anterior and posterior annular length,annular area(MAA) and non-planar angel(NPA).The dynamic changes during the cardiac cycle were calculated.Results Compared with control group,the posterior annular length and NPA significantly increased in IMR group(P<0.05,P<0.01).During the systole,the posterior annular and annular circumference paradoxically prolonged in IMR group compared with control group(median Δ posterior annular length:-2.71 mm/m2 vs 0.52 mm/m2,P<0.05).In all patients of non-IMR group,the geometric character of mitral valve lesions shown in 3-dimensional echocardiography was accordant with surgical findings.Conclusion Three-dimensional echocardiography combined with MVA software provides a useful tool for assessment the geometric character of mitral valve lesions and quantification of mitral annulus remodeling,which is helpful to understand the mechanism of MR and guide surgical treatment.更多还原