Real-time three-dimensional color Doppler evaluation of the flow convergence zone for quantification of mitral regurgitation: Validation experimental animal study and initial clinical experience
Real-time three-dimensional color Doppler evaluation of the flow convergence zone for quantification of mitral regurgitation: Validation experimental animal study and initial clinical experience
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DOI：
10.1067/mje.2003.37
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发表时间：
2003-01-01
影响因子：
6.5
通讯作者：
Thomas, JD
中科院分区：
文献类型：
--
作者：
Sitges, M;Jones, M;Thomas, JD
背景资料：血流会聚（FC）方法的缺陷（包括FC表面的三维（3D）几何结构的二维成像）可能导致二尖瓣返流（MR）的错误量化。这种局限性可以通过使用实时3D彩色多普勒超声心动图（CE）来缓解。我们的目的是验证MR quantitation.Methods的实时3D导航方法：在12只羊手术诱导的慢性MR，37个不同的血流动力学条件进行了研究，与实时3DCE。使用实时3D导航，定位并测量最大半球形FC区的半径。在三维空间观察FC的形态后，根据FC方法对MR体积进行定量。主动脉和二尖瓣电磁流量探头和流量计相互平衡，以确定参考MR体积。作为初步的临床应用研究，22例慢性MR患者也进行了研究与此实时3DCE-FC方法。使用左心室（IV）流出道自动心流量测量（Toshiba Corp，Tokyo，Japan）和实时3D IV每搏输出量来量化参考MR体积（MR体积= 3DLV每搏输出量自动心流量测量）。在绵羊模型中，通过实时3DCE和电磁测量的MR体积之间具有良好的相关性和一致性（y = 0.77X + 1.48，r = 0.87，P <0.001，Delta = -0.91 +/- 2.65 mL）。在患者中，实时3DCE导出的MR体积也显示出与参考方法的良好相关性和一致性（y = 0.89x - 0.38，r = 0.93，P <0.001，A-4.8 +/- 7.6 mL）。结论：实时3DCE可以捕获整个FC图像，允许FC区几何形状的几何识别和可靠的MR定量。
Background: Pitfalls of the flow convergence (FC) method, including 2-dimensional imaging of the 3-dimensional (3D) geometry of the FC surface, can lead to erroneous quantification of mitral regurgitation (MR). This limitation may be mitigated by the use of real-time 3D color Doppler echocardiography (CE). Our objective was to validate a real-time 3D navigation method for MR quantification.Methods: In 12 sheep with surgically induced chronic MR, 37 different hemodynamic conditions were studied with real-time 3DCE. Using real-time 3D navigation, the radius of the largest hemispherical FC zone was located and measured. MR volume was quantified according to the FC method after observing the shape of FC in 3D space. Aortic and mitral electromagnetic flow probes and meters were balanced against each other to determine reference MR volume. As an initial clinical application study, 22 patients with chronic MR were also studied with this real-time 3DCE-FC method. Left ventricular (IV) outflow tract automated cardiac flow measurement (Toshiba Corp, Tokyo, Japan) and real-time 3D IV stroke volume were used to quantify the reference MR volume (MR volume = 3DLV stroke volume automated cardiac flow measurement).Results. In the sheep model, a good correlation and agreement was seen between MR volume by real-time 3DCE and electromagnetic (y = 0.77X + 1.48, r = 0.87, P < .001, Delta = -0.91 +/- 2.65 mL). In patients, real-time 3DCE-derived MR volume also showed a good correlation and agreement with the reference method (y = 0.89x - 0.38, r = 0.93, P < .001, A -4.8 +/- 7.6 mL).Conclusions: real-time 3DCE can capture the entire FC image, permitting geometrical recognition of the FC zone geometry and reliable MR quantification.