Sugioka Kenichi, Hozumi Takeshi, Watanabe Hiroyuki, Yamagishi Hiroyuki, Matsumura Yoshiki, Takemoto Yasuhiko, Muro Takashi, Yoshiyama Minoru, Takeuchi Kazuhide, Yoshikawa Junichi
Department of Internal Medicine and Cardiology, Osaka City University Medical School, Japan.
J Am Soc Echocardiogr. 2003 Dec;16(12):1237-43. doi: 10.1067/j.echo.2003.08.014.
The advanced automated contour tracking (AACT) method has been newly developed for automated detection of the left ventricular endocardial boundary. Left ventricular ejection fraction (LVEF) may be estimated by applying the AACT method to 2 orthogonal planes of patients even when regional wall-motion abnormalities exist. The purpose of this study was to examine the reliability of the biplane AACT method in the measurement of LVEF in patients with suggested ischemic heart disease with use of quantitative gated single photon emission computed tomography (QGS) as a reference standard.
The study population consisted of 47 consecutive patients with suggested ischemic heart disease. All patients underwent 2-dimensional echocardiography and QGS. Biplane LVEF from apical 4- and 2-chamber views was measured offline by the AACT method using disk summation method. The accuracy of the AACT method for LVEF measurement was determined in comparison with QGS.
In 41 (29 with and 12 without regional wall-motion abnormalities) of 47 patients (87%), automated tracing of the endocardial border was adequately achieved with the AACT method. LVEF measured by the AACT method correlated well with that measured by QGS (y = 0.97x +2.4, r = 0.91). The mean difference between AACT and QGS was 0.6 +/- 5.5% (mean +/- SD). The mean time required for analysis of 1 set of images during 1 cardiac cycle by the AACT method was much shorter than that required by manual tracing method (7 +/- 1 vs 37 +/- 4 seconds, P <.0001).
The biplane AACT method provides accurate and quick measurement of LVEF in patients even with regional wall-motion abnormalities.
先进的自动轮廓跟踪(AACT)方法是新开发的用于自动检测左心室心内膜边界的方法。即使存在局部室壁运动异常,将AACT方法应用于患者的两个正交平面也可估计左心室射血分数(LVEF)。本研究的目的是使用定量门控单光子发射计算机断层扫描(QGS)作为参考标准,检验双平面AACT方法在测量疑似缺血性心脏病患者LVEF中的可靠性。
研究人群包括47例连续的疑似缺血性心脏病患者。所有患者均接受二维超声心动图和QGS检查。使用圆盘求和法,通过AACT方法离线测量心尖四腔和两腔视图的双平面LVEF。与QGS比较,确定AACT方法测量LVEF的准确性。
47例患者中的41例(87%,其中29例有局部室壁运动异常,12例无局部室壁运动异常)通过AACT方法充分实现了心内膜边界的自动追踪。AACT方法测量的LVEF与QGS测量的LVEF相关性良好(y = 0.97x +2.4,r = 0.91)。AACT与QGS之间的平均差异为0.6 +/- 5.5%(平均值 +/- 标准差)。AACT方法分析一个心动周期中一组图像所需的平均时间比手动追踪方法所需的时间短得多(7 +/- 1秒对37 +/- 4秒,P <.0001)。
双平面AACT方法即使在存在局部室壁运动异常的患者中也能准确、快速地测量LVEF。