【摘要】 目的评价实时三维超声心动图(RT-3DE)估测心室搏出量的可行性和准确性。方法以Swan-Ganz导管热稀释法测定的心室搏出量为标准,应用Philips RT-3DE系统采集10头健康猪心“金字塔形”数据库,结合TomTec4D Cardio-View RT测量软件用心尖长轴8平面法测量左、右室舒张末期和收缩末期容量,计算左、右室搏出量,并与二维超声双平面Si mpson法测值比较。结果所有猪心均获满意的左、右室RT-3DE显示,其形态与直视下猪心心室实际形态相似。其中,RT-3DE8平面法估测左室搏出量[(24.58±3.44)ml]与其右室搏出量[(23.58±3.18)ml]呈高度相关(r=0.93),并与Swan-Ganz导管热稀释法测值[(25.64±3.18)ml]有良好相关性(r=0.85,r=0.92)。经方差分析、SNK均数间两两比较检验,三者间差异无统计学意义(P>0.05)。而二维超声双平面Si mpson法估测左室搏出量[(16.83±4.71)ml]与其右室搏出量[(10.10±2.87)ml]与Swan-Ganz导管热稀释法测值仅呈低度相关(r=0.59,r=0.39),尤以右室搏出量低估程度较明显,且其左、右室搏出量间相关性较低(r=0.76)。经方差分析、SNK检验,三者间差异有统计学意义(P<0.05)。结论RT-3DE是估测心室搏出量的可靠手段。更多还原

【Abstract】 Objective To evaluate the feasibility and accuracy of real-time three-dimensional echocardiography (RT-3DE) in quantifying ventricular stroke volume in an in vivo experimental study.Methods Ten porcine hearts were examined by RT-3DE and conventional two-dimensional echocardiography (2DE) with Philips Sonos 7500 ultrasound system.The left and right ventricular stoke volume examined by RT-3DE was outlined and calculated by 8-plane method with the 4D Cardio-View RT of TomTec image system,and the results were compared with those of 2DE biplane Simpson-method.The values of ventricular stroke volume measured by Swan-Ganz pulmonary thermodilution method were served as reference values.Results “Full volume” imaging in all porcine hearts was well displayed by RT-3DE.The ventricular shapes displayed by RT-3DE were similar to the anatomic ventricular shapes.From the findings of analysis of variance and Student-Newman-Keuls test,there was no significant difference (P> 0.05 ) between the left ventricular stroke volume with RT-3DE ( 24.58 ± 3.44 )ml,the right ventricular stroke volume with RT-3DE ( 23.58 ± 3.18 )ml and those values measured with Swan-Ganz pulmonary thermodilution method ( 25.64 ± 3.18 )ml.Furthermore,there was well correlation between the left ventricular stroke volume and the right ventricular stroke volume with RT-3DE (r= 0.93 ).They were also well correlated with those values with Swan-Ganz pulmonary thermodilution method (r= 0.85 ,r= 0.92 ).However,there was significant difference (P< 0.05 ) between the left ventricular stroke volume with 2DE ( 16.83 ± 4.71 )ml,the right ventricular stroke volume with 2DE ( 10.10 ± 2.87 )ml and those values with Swan-Ganz pulmonary thermodilution method.Moreover,the right ventricular stroke volume with 2DE was underestimated more than the left ventricular stroke volume with 2DE.There was poor correlation between them (r= 0.76 ).They were also poorly correlated with those values measured with Swan-Ganz pulmonary thermodilution method (r= 0.59 ,r= 0.39 ).Conclusions RT-3DE is a valuable and accurate technique to quantify ventricular stroke volume.更多还原