Ahmed Sujood, Nanda Navin C, Miller Andrew P, Nekkanti Rajasekhar, Yousif Abdalla M, Pacifico Albert D, Kirklin James K, McGiffin David C
Division of Cardiovascular Diseases, The University of Alabama at Birmingham, Birmingham, AL, USA.
Ultrasound Med Biol. 2002 Nov-Dec;28(11-12):1389-93. doi: 10.1016/s0301-5629(02)00647-6.
As compared with two-dimensional (2-D) transesophageal echocardiography (TEE), 3-D echocardiography now permits more realistic visualization of cardiac anatomy and of intracardiac lesions. The aim of this study was to apply newer 3-D echocardiographic techniques to quantify volumes of intracardiac masses undergoing surgical resection seen during an intraoperative TEE. The calculated volumes were compared with actual in vitro measurements of surgically resected masses. A total of 14 patients (9 men; 5 women; age range between 21 and 77 years) with intracardiac mass lesions (4 tumors: 3 left atrial myxomas and 1 mitral valve fibroelastoma, and 10 vegetations: 5 aortic valve, 3 mitral valve, 1 tricuspid and 1 pulmonary valve) were studied. Using commercially available 3-D reconstruction software (TomTec v. 4.1), the volumes of intracardiac masses were estimated using both the average rotation (rotation around the long axis, AR) and disk summation (parallel short axis cuts, DS) methods. Volumes of these lesions were also measured in vitro by water submersion. They ranged from 0.20 mL to 24 mL (mean +/- SD = 8.07 +/- 9.21 mL). Both 3-D TEE AR and 3-D TEE DS calculated volumes correlated excellently with in vitro measured volumes (r = 1.00 and r = 0.98, respectively, p = < 0.0001). The correlation between 3-D TEE AR and 3-D TEE DS calculated volumes was also excellent (r = 0.98, p = < 0.0001). In conclusion, the volume assessments by 3-D TEE of intracardiac mass lesions correlated well with in vitro measured volumes of surgical specimens. This technique may prove to be valuable in further defining intracardiac pathology and is a further advancement toward the application of clinically useful 3-D echocardiography.
与二维（2-D）经食管超声心动图（TEE）相比，三维超声心动图现在能够更真实地显示心脏解剖结构和心内病变。本研究的目的是应用更新的三维超声心动图技术，对术中TEE检查时发现的接受手术切除的心内肿块体积进行量化。将计算出的体积与手术切除肿块的实际体外测量值进行比较。共研究了14例心内肿块病变患者（9例男性；5例女性；年龄范围在21至77岁之间）（4个肿瘤：3个左心房黏液瘤和1个二尖瓣纤维弹性瘤，以及10个赘生物：5个主动脉瓣、3个二尖瓣、1个三尖瓣和1个肺动脉瓣）。使用市售的三维重建软件（TomTec v. 4.1），采用平均旋转法（绕长轴旋转，AR）和平行短轴切面法（DS）估计心内肿块的体积。这些病变的体积也通过水浸法进行体外测量。其范围为0.20 mL至24 mL（平均值±标准差= 8.07±9.21 mL）。三维TEE的AR法和DS法计算出的体积与体外测量体积均具有极好的相关性（r分别为1.00和0.98，p = < 0.0001）。三维TEE的AR法和DS法计算出的体积之间的相关性也非常好（r = 0.98，p = < 0.0001）。总之，三维TEE对心内肿块病变的体积评估与手术标本的体外测量体积相关性良好。该技术可能在进一步明确心内病理方面具有价值，并且是朝着临床实用的三维超声心动图应用迈出的又一进步。
