实时三维超声心动图对COPD病人右心室功能评估价值

摘要

目的:探讨应用实时三维超声心动图(RT-3DE)定量评价慢性阻塞性肺疾病(COPD)病人右心室功能,并对比磁共振MRI,评价RT-3DE在右心功能评估中的价值.方法:对26例COPD病人于24 h内均行心脏RT-3DE和MRI检查.行RT-3DE全容积显像方式采集图像数据后行图像后处理,构建右心室三维模型并进行心功能测量,最后得到舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)和射血分数(EF)四项心功能指标的平均值.并同时应用MRI多次屏气电影法测量相应的四项右心室功能指标.结果:超声测得的各项心功能指标值分别为EDV(118.35±13.83)mL,ESV(66.74±14.27)mL,SV(49.16±12.38)mL,EF(45.14±6.74)%,而MRI测得的心功能指标值分别为:EDV(124.63±21.52)mL,ESV(62.18±12.34)mL,SV(51.25±15.83)mL,EF(46.32±7.11)%,2种方法检测的各项指标差异均无统计学意义(P>0.05),且均无正相关关系(P>0.05).结论:RT-3DE在COPD病人右心功能定量评价方面准确可靠,与3.0T MRI评价COPD病人右心功能各指标均无相关关系.%Objective:To investigate the value between three-dimensional real-time echocardiography(RT-3DE) and magnetic resonance imaging(MRI) in the assessment of right ventricular function of patients with chronic obstructive pulmonary disease(COPD).Methods:The hearts of 26 patients with COPD were detected by RT-3DE and MRI.The image data were collected using RT-3DE full-volume imaging capture to contract three dimensional model of right ventricular for measuring the mean of the end-diastolic volume(EDV),end-systolic volume(ESV),stroke volume(SV) and ejection fraction(EF).Meanwhile,the four indexes of right ventricular function were measured using MRI several breath-hold cine.Results:The means of EDV,ESV,SV and EF measured by echocardiography were(118.35±13.83) mL,(66.74±14.27)mL,(49.16±12.38)mL and(45.1±6.7)%,respectively,the means of EDV,ESV,SV and EF measured by MRI were(124.63±21.52)mL,(62.18±12.34)mL,(51.25±15.83)mL and(46.3±7.1)%,respectively.The differences of four indexes measured by two kinds of methods were not statistically significant(P>0.05),which was no correlation between 2 methods(P>0.05).Conclusions:The RT-3DE in evaluating the right ventricular function in COPD patient is accurate and reliable,which is high correlation with the indexes measured by MRI.