Reproducibility of right ventricular volumes and ejection fraction using real-time three-dimensional echocardiography - Comparison with cardiac MRI
Reproducibility of right ventricular volumes and ejection fraction using real-time three-dimensional echocardiography - Comparison with cardiac MRI
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DOI：
10.1378/chest.06-2143
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发表时间：
2007-06-01
期刊：
影响因子：
9.6
通讯作者：
Marwick, Thomas H.
中科院分区：
文献类型：
--
作者：
Jenkins, Carly;Chan, Jonathan;Marwick, Thomas H.
目的：右室(RV)的非几何性质使其难以测量。方法：应用实时三维超声心动图(RT3DE)、实时三维超声心动图(RT3DE)和核磁共振(MRI)对50例左室湾运动异常患者的右室容量和射血分数(EF)进行研究，包括面积长度[A-L]法、改良二维减影[2DS]法和Simpson法。在不改变血流动力学或治疗的情况下，在24小时内使用单独的超声仪进行完全的再研究来执行测试-重新测试变异。在20名患者的亚组中观察到观察者间和观察者内的差异。结果：使用每种技术估计的EF是相似的。平均(+/-SD)MRI舒张末容量(87+/-22毫升)仅被RT3DE(平均差值-3+/-10；p<；0.05)轻微低估，其中2DE A-L(-29+/-10；p<；0.05)和Simpson法(-29+/-10；p<；0.05)的平均差值较大，而2DS(平均差值26+/-23；p<；0.05)则被大大高估。同样，与2DE A-L(-16+/-8；p<；0.05)和Simpson法(16+/-8；p<；0.05)相比，RT3DE(-4+/-7；p<；0.05)仅轻微低估了MRI收缩末期容积(46+/-17mL)，而2DS(14+/-13；p<；0.05)则高估了这一数值。RT3DE结果与各参数的相关性高于任何2DE技术。两位超声师的RT3DE之间也有很好的观察者内和观察者间的相关性。结论：RT3DE较二维法更准确，减少了RV体积和EF测量的重测变异，可用于RV随访评估。
Objectives: The nongeometric nature of the right ventricle (RV) makes it difficult to measure. We sought to determine whether real-time three-dimensional echocardiography (RT3DE) is superior to two-dimensional echocardiography (2DE) for the follow-up, of RV function by validation vs cardiac MRI.Methods: RV volumes and ejection fraction (EF) were studied with 2DE (including area-length [A-L], the modified two-dimensional subtraction [2DS] method, and the Simpson method of discs), RT3DE, and MRI in 50 patients with left ventricular wan motion abnormalities, the results of which suggested possible RV infarction. Test-retest variation was performed by a complete restudy using a separate sonographer within 24 h without the alteration of hemodynamics or therapy. Interobserver and intraobserver variations were noted in a subgroup of 20 patients.Results: EF estimations were similar using each technique. The mean (+/- SD) MRI end-diastolic volume (87 +/- 22 mL) was only slightly underestimated by RT3DE (mean difference, -3 +/- 10; p < 0.05), with a greater mean difference for 2DE A-L (-29 +/- 10; p < 0.05), and the Simpson method of discs (-29 23; p < 0.05), and was greatly overestimated by 2DS (mean difference, 26 +/- 23; p < 0.05). Similarly, the mean MRI end-systolic volume (46 +/- 17 mL) was only slightly underestimated by RT3DE (-4 +/- 7; p < 0.05), compared with 2DE A-L (-16 +/- 8; p < 0.05) and the Simpson method of discs (16 +/- 8; p < 0.05), and was overestimated by 2DS (14 +/- 13; p < 0.05). RT3DE findings had a higher correlation with each parameter than any 2DE technique. There was also good intraobserver and interobserver correlation between RT3DE by two sonographers. RT3DE had less test-retest variation of RV volumes and EF than any 2DE measure.Conclusions: RT3DE is more accurate than two-dimensional approaches and reduces the test-retest variation of RV volumes and EF measurements in follow-up RV assessment.