摘要
目的采用经胸实时三维超声心动图(RT-3D-TTE)探讨功能性二尖瓣反流(FMR)患者二尖瓣的结构及功能的变化规律。方法对70例中度及中度以上FMR患者(FMR组;缺血性心肌病、扩张型心肌病亚组各35例)和30名健康志愿者(对照组)分别行RT-3D-TTE检查,采用TomTec二尖瓣分析软件获取二尖瓣参数,分析二尖瓣参数时相变化规律,比较FMR组与对照组间二尖瓣参数的差异。测量参数包括二尖瓣环结构参数:瓣环前后直径(AP)、前外侧至后内侧直径(AL-PM)、球度指数(SPI,SPI=AP/AL-PM)、瓣环周长(AC)、连合处直径(CD)、非平面角度(NPA)、瓣环高度(AH)、幕状区高度(TH)、幕状区容积(TV)、瓣环三维面积(AA_(3D));动态参数:瓣环最大位移(AD_(max))、瓣环最大位移速率(ADV_(max))。结果 FMR组二尖瓣参数存在时相性变化规律。FMR组AH、AD_(max)及ADV_(max)小于对照组(P均<0.05),余参数均大于对照组(P均<0.05)。缺血性心肌病亚组、扩张型心肌病亚组AH、AD_(max)及ADV_(max)均小于对照组(P均<0.05),余参数均大于对照组(P均<0.05);扩张型心肌病亚组AH小于缺血性心肌病亚组(P<0.05),AD_(max)、ADV_(max)两组间差异无统计学意义(P均>0.05),余参数均大于缺血性心肌病亚组(P均<0.05)。结论 RT-3D-TTE可以定量评价FMR患者二尖瓣形态及功能的变化,为其临床治疗提供参考依据。
Objective To investigate the structural and functional changes of mitral valve in patients with functional mitral regurgitation（FMR）by real-time three-dimensional transthoracic echocardiography（RT-3D-TTE）.Methods RT-3DTTE were performed on 70 patients with at least moderate mitral regurgitation（FMR group;including 35 cases of ischemic cardiomyopathy[ICM]subgroup and 35 cases of dilated cardiomyopathy[DCM]subgroup）and 30 normal controls（control group）.The mitral valve parameters were analyzed by TomTec assessment software to detect dynamic changing pattern of mitral valve size and shape during cardiac systole.The differences of parameters between control group and FMR group were compared.The parameters included mitral annulus structural parameters：Anterior-posterior（AP）,anterolateral-posteromedial（AL-PM）,sphericity（SPI;SPI=AP/AL-PM）,annular circumference（AC）,commissural diameter（CD）,nonplanarity angle（NPA）,annular height（AH）,tenting height（TH）,tenting volume（TV）,three-dimensional annular area（AA3D）;dynamic parameters：Maximum annular displacement（ADmax）,maximum annular displacement velocity（ADVmax ）.Results The mitral valve parameters present phasic variation law in FMR group.Compared with control group,AH,ADmax and ADVmax were smaller and the other parameters were larger than those in FMR group（all P〈0.05）.Compared with control group,AH,ADmax and ADVmax were smaller and the other parameters were larger than those in both ICM subgroup and DCM subgroup（all P〈0.05）.Compared with ICM subgroup,AH was smaller in DCM subgroup（P〈0.05）,there was no statistical difference in ADmax and ADVmax between ICM subgroup and DCM subgroup（P〉0.05）,the rest parameters were greater in DCM group（all P〈0.05）.Conclusion RT-3D-TTE can be used to quantitatively assess the structural and functional changes of mitral valve in patients with FMR and provide a reference for the clinical treatment of FMR.
出处
《中国医学影像技术》
CSCD
北大核心
2017年第3期330-334,共5页
Chinese Journal of Medical Imaging Technology
关键词
超声心动描记术
三维
二尖瓣功能不全
Echocardiography
Three-dimensional
Mitral valve insufficiency
