Measurement of Left Atrial Volume from Transthoracic Three-Dimensional Echocardiographic Datasets Using the Biplane Simpson's Technique
Measurement of Left Atrial Volume from Transthoracic Three-Dimensional Echocardiographic Datasets Using the Biplane Simpson's Technique
复制标题
DOI：
10.1016/j.echo.2012.08.017
复制
发表时间：
2012-12-01
影响因子：
6.5
通讯作者：
Otsuji, Yutaka
中科院分区：
文献类型：
--
作者：
Iwataki, Mai;Takeuchi, Masaaki;Otsuji, Yutaka
背景：虽然二维(2D)超声心动图测量的左房容积(LAV)可提供预后信息，但左房2D切面的错位可能会使测量结果不准确。本研究的目的是验证使用双平面Simpson技术从三维(3D)超声心动图数据集测量LAV是一种更可靠的测量LAV的方法的假设。方法：以多层计算机断层扫描为参照，回顾分析20例患者三维超声心动图测量LAV的准确性。用二维和三维超声心动图测量了200名其他受试者的LAV与体表面积指数(LAVI)。二维超声心动图左心功能测定采用双平面Simpson法。结果：虽然三维容积法(平均98+/-24毫升)的左房血容量(LAV)略低于多层螺旋CT的左房血容量(103+/-23毫升)，但两种方法之间有显著的相关性(r=0.97，P<；.001)，符合可接受的范围。从3D数据集提取的左房短轴图像显示为椭圆形。二维双平面Simpson法与三维容积法的LAVI有很好的相关性(r=0.96，P&t；.001)，但二维超声心动图的平均LAVI明显大于三维超声心动图的LAVI，平均偏差为4.7mL/m(2)。3D双平面Simpson‘s法和3D容积法之间具有良好的相关性(r=0.99，P<；.001)，偏倚较低(0.54mL/m(2))，符合限为+/-5.8mL/m(2)。二维(平均82+/-7秒)和三维(平均94+/-11秒)双平面Simpson法(P<；0.01vs 2D双平面Simpson法)所需时间显著少于3D双平面Simpson法(平均135±24秒)(P<；0.01vs 2D和3D双平面Simpson法)。结论：2D双平面Simpson法由于2D切面的错位而高估了LAV，3D双平面Simpson法是一种更实用、更可靠的准确确定LAV的方法。(J Am Soc超声心动图2012；25：1319-26。)
Background: Although left atrial volume (LAV) by two-dimensional (2D) echocardiography provides prognostic information, the misalignment of the 2D cutting plane of the left atrium could make the measurements inaccurate. The aim of this study was to test the hypothesis that LAV measurement from three-dimensional (3D) echocardiographic data sets using the biplane Simpson's technique is a more reliable approach for measuring LAV.Methods: The accuracy of 3D echocardiographic LAV measurements was retrospectively determined in 20 patients using multidetector computed tomography as a reference. LAV indexed to body surface area (LAVI) was measured using 2D and 3D echocardiography in 200 other subjects. LAV determination by 2D echocardiography was performed using the biplane Simpson's method. A 3D determination of LAV was performed using quantitative software and the biplane Simpson's method using the anterior-posterior and medial-lateral 2D views extracted from the 3D data sets.Results: Although LAV using the 3D volumetric method (mean, 98 +/- 24 mL) was slightly but significantly lower than LAV on multidetector computed tomography (mean, 103 +/- 23 mL), a significant correlation between the two methods (r = 0.97, P < .001) with acceptable limits of agreement was noted. The left atrial short-axis image extracted from the 3D data sets revealed an ellipsoid shape. Although a good correlation for LAVI was noted between the 2D biplane Simpson's method and the 3D volumetric method (r = 0.96, P < .001), the mean value of 2D echocardiographic LAVI was significantly greater compared with 3D echocardiographic LAVI, with a mean bias of 4.7 mL/m(2). An excellent correlation was noted between the 3D biplane Simpson's and 3D volumetric methods (r = 0.99, P < .001), with a lower bias (0.54 mL/m(2)) and limits of agreement of +/-5.8 mL/m(2). The time required for LAV analysis was significantly shorter with the 2D (mean, 82 +/- 7 sec) and 3D (mean, 94 +/- 11 sec) biplane Simpson's methods (P < .01 vs 2D biplane Simpson's method) compared with the 3D volumetric methods (mean, 135 +/- 24 sec) (P < .01 vs 2D and 3D biplane Simpson's methods).Conclusions: The 2D biplane Simpson's method overestimates LAV because of the misalignment of the 2D cutting plane, and the 3D biplane Simpson's method is a practical and more reliable way to accurately determine LAV. (J Am Soc Echocardiogr 2012; 25: 1319-26.)