Echocardiographic Anatomy of the Mitral Valve: A Critical Appraisal of 2-Dimensional Imaging Protocols With a 3-Dimensional Perspective
Echocardiographic Anatomy of the Mitral Valve: A Critical Appraisal of 2-Dimensional Imaging Protocols With a 3-Dimensional Perspective
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DOI：
10.1053/j.jvca.2012.06.017
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发表时间：
2012-10-01
影响因子：
2.8
通讯作者：
Maslow, Andrew
中科院分区：
文献类型：
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作者：
Mahmood, Feroze;Hess, Philip E.;Maslow, Andrew
目的：强调传统二维超声二尖瓣(MV)检查方法的局限性，该方法不考虑在实际临床围术期检查中对患者特定的经食道超声心动图(TEE)探头的调整。设计：机构质量改进项目。设置：三级护理医院。参与者：由国家超声心动图委员会认证的主治麻醉师。干预：使用三维(3D)数据的多平面重建技术，生成模糊的MV 2D图像，类似于标准的食道中段2D视图。在3D图像的基础上，通过扫描平面的位置准确地识别每个2D图像中显示的MV扇贝。23个这样的2D MV图像是在3D数据集的演示中创建的。麻醉工作人员(n=13)被邀请观看仅基于2D图像的演示，并被要求识别MV扇贝。根据3D图像对他们的反应进行正确或不正确的评分。方法和主要结果：MV扇贝识别的总体准确率为30.4%。90%的时间正确地识别了跨连合的观点。A1、A3、P1和P3扇贝的识别准确率为50%。结论：在缺乏TEE探头调整以获得特定MV图像的信息的情况下，可能会对扇贝进行错误识别。C)2012 Elsevier Inc.保留所有权利。
Objective: To highlight the limitations of traditional 2-dimensional (2D) echocardiographic mitral valve (MV) examination methodologies, which do not account for patient-specific transesophageal echocardiographic (TEE) probe adjustments made during an actual clinical perioperative TEE examination.Design: Institutional quality-improvement project.Setting: Tertiary care hospital.Participants: Attending anesthesiologists certified by the National Board of Echocardiography.Intervention: Using the technique of multiplanar reformatting with 3-dimensional (3D) data, ambiguous 2D images of the MV were generated, which resembled standard midesophageal 2D views. Based on the 3D image, the MV scallops visualized in each 2D image were recognized exactly by the position of the scan plane. Twenty-three such 2D MV images were created in a presentation from the 3D datasets. Anesthesia staff members (n = 13) were invited to view the presentation based on the 2D images only and asked to identify the MV scallops. Their responses were scored as correct or incorrect based on the 3D image.Methods and Main Results: The overall accuracy was 30.4% in identifying the MV scallops. The transcommissural view was identified correctly >90% of the time. The accuracy of the identification of A1, A3, P1, and P3 scallops was = 50%.Conclusion: In the absence of information on TEE probe adjustments performed to acquire a specific MV image, it is possible to misidentify the scallops. C) 2012 Elsevier Inc. All rights reserved.