【摘要】 目的探讨三维彩色多普勒缩流面积(VCA)量化二尖瓣反流(MR)的价值。方法 60例MR患者,使用二维血流会聚法有效反流孔面积(EROA)和反流容积等指标对MR进行量化和分级,使用三维彩色多普勒全容积数据重建反流束并测量VCA。分析VCA的诊断价值及与EROA相关性和差异性。结果不同程度MR组间VCA有统计学差异。ROC曲线分析VCA诊断重度MR曲线下面积0.88(P<0.001),截断值取0.36 cm~2时,灵敏度87%,特异度82%。功能性二尖瓣反流组VCA较EROA大0.10 cm~2,有统计学差异(P<0.01)。结论 VCA能简单、直观、准确的量化评价二尖瓣反流程度。更多还原

【Abstract】 Objective To investigate the diagnostic value of vena contracta area(VCA) in the quantification of mitral regurgitation(MR) severity by color Doppler 3D echocardiography.Methods 60 patients with different degree of MR were included in the study.They were graded into 4 groups by effective regurgitation orifice area(EROA) and regurgitation volume indicators by 2D echocardiography proximal isovelocity surface area method.VCA were reconstructed and measured by use of color Doppler 3D echocardiography full volume data.The diagnostic value of VCA and the correlation and difference with EROA were analyzed.Results The VCA had significant differences among different MR grades,the area under the receiver operating characteristic curve was 0.88(P<0.001),the best cutoff value of 0.36 cm~2 yielded 87%of sensitivity and 82%of specificity to differentiate moderate from severe MR.There was significant difference between EROA and VCA in patients with FMR,resulting in an underestimation of regurgitation orifice area about 0.10 cm~2 by 2D PISA(P<0.01).Conclusions 3D VCA provides a simple,directly visualized and reliable measurement of regurgitation orifice area by eliminating geometric and flow assumptions.更多还原