目的 以指南推荐的"二维综合方法"作为二尖瓣反流(MR)严重程度的分级标准,探讨全身成像三维量化(GI3DQ)法测量的二尖瓣反流束体积(MRvol)在不同类型MR严重程度中的诊断价值.方法 93例MR患者分两组:中心性MR组41例,偏心性MR组52例.依据"二维综合方法"将MR患者分为轻、中、重度.GI3DQ法直接测量MRvol.结果 中心性MR组ROC曲线分析示:GI3DQ法测量的MRvol>16.2 ml时,ROC曲线下面积为0.87(P<0.0001),区分轻度和中度MR的敏感性为96.2%,特异性为63.6%;MRvol>47.8 ml时,ROC曲线下面积为0.98(P<0.0001),区分中度和重度MR的敏感性为98.6%,特异性为96.2%.偏心性MR组ROC曲线分析示:MRvol>14.8 ml时,ROC曲线下面积为0.76(P=0.086),区分轻度和中度MR的敏感性为90.9%,特异性为60.0%;MRvol>40.7 ml时,ROC曲线下面积为0.84(P<0.0001),区分中度和重度MR的敏感性为80.0%,特异性为79.7%.结论 GI3DQ法直接测量MRvol可较为准确地评估MR严重程度,尤其在中心性MR组,区分中度和重度MR时,拥有更高敏感性和特异性.%Objective To evaluate diagnostic value of mitral regurgitation jet volume(MRvol) in the quantification of mitral regurgitation severity by general imaging three-dimensional quantification (GI3DQ) using the guideline recommended 2D integrative method as a reference.Methods Ninety-three patients with MR were divided into central MR group(n =41) and eccentric MR group(n =52).The American Society of Echocardiography (ASE)-recommended 2D integrative method was used as a reference for MR grading and MRvol was directly measured by GI3DQ method.Results In central MR,as assessed by receiver operating characteristic (ROC) analysis,the area under the curve(AUC)was 0.87(P <0.0001), and MRvol by GI3DQ at a cutoff value of 16.2 ml yielded 96.2% of sensitivity and 63.6% of specificity to differentiate mild from moderate MR;the AUC was 0.98(P < 0.0001),and a cutoff value of 47.8 ml yielded 98.6% of sensitivity and 96.2% of specificity to differentiate moderate from severe MR. In eccentric MR,the AUC was 0.76(P =0.086),and MRvol at a cutoff value of 14.8 ml yielded 90.9% of sensitivity and 60.0% of specificity to differentiate mild from moderate MR;the AUC was 0.84(P <0.0001) and a cutoff value of 40.7 ml yielded 80.0% of sensitivity and 79.7% of specificity to differentiate moderate from severe MR.Conclusions MRvol measured directly by GI3DQ could more exactly evaluate MR severity,and have better sensitivity and specificity to differentiate moderate from severe MR in central MR.
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