经食管实时三维超声心动图对二尖瓣立体结构的定量研究

摘要

Objective To investigate the clinical value of mitral valve quantitative(MVQ)soft ware,select the significant parameters in diagnosing mitral valve prolapse and analysis the mechanism of mitral valve regurgitation by MVQ in clinical.Methods Live three dimensional transesophageal echocardiography was performed on thirty-one patients,in which 13 patients with mitral valve prolapse,another 18 patients with suspected intracardiac thrombosis without mitral valve regurgitation regarded as control group.The images were stored and processed with MVQ soft ware off line.Eighteen parameters of mitral valve structure were measured in mitral valve 3D mode.Results Comparing with the control group,the parameters of mitral valve annulus of mitral valve prolapse were larger significantly(P＜0.05).Seven parameters of mitral valve leaflets,θant,θpost,θNPA,Htent,Vtent,L2DALPm,θAv-Mv,had no significant difference between tWO groups(P＞0.05).L3Dant,L3Dpost,Hprol,Vprol,A3Dpost,A3Dant of mitral valve prolapse were larger than those of control group(P＜0.05).Conclusions MVQ can measure the parameters of mitral valve stereo structure quantitatively,result in more detailed diagnosis of mitral valve disease by echocardiography,provide more important information to surgeons,and help them to formulate detailed and complete operation scheme.%目的 探讨经食管实时三维超声心动图二尖瓣立体结构定量分析(MVQ)软件的临床价值,筛选出对诊断二尖瓣脱垂和分析二尖瓣反流机制有意义的参数.方法 对18例无二尖瓣反流、瓣膜结构功能正常患者(对照组)和13例二尖瓣脱垂引起大量二尖瓣反流患者(脱垂组),分别行经食管实时三维超声检查,应用MVQ进行后处理,测量收缩期关于二尖瓣立体结构的18个参数.统计两组中有统计学意义的参数.结果 脱垂组的二尖瓣瓣环参数均较对照组增大,差异有统计学意义(P＜0.05).瓣叶的参数关闭时前叶瓣体与瓣环最高平面的夹角(θant)、关闭时后叶瓣体与瓣环最高平面的夹角(θpost)、关闭时前叶与后叶瓣体对合时形成的夹角(θNPA)、瓣叶关闭时穹隆高度(Htent)、瓣叶穹隆的容积(Vtent)、前后叶关闭时对合线的长度(L2DALPm)、主动脉瓣环与二尖瓣环平面夹角(OAv-Mv)两组间比较差异无统计学意义(P＞0.05).前叶自瓣根至对合线的长度(L3Dant)、后叶从瓣根至对合线的长度(L3Dpost)、脱垂瓣叶向左房侧隆起的高度(Hprol)、脱垂部分的容积(Vprol)、后叶瓣体的面积(A3Dpost)、前叶瓣体的面积(A3Dant)脱垂组均大于对照组,差异有统计学意义(P＜0.05).结论 MVQ分析软件可以定量测量二尖瓣的立体结构,使超声心动图对瓣膜病变的诊断更加详细量化,对外科制定精确的手术方案具有重要的指导意义.