Macnab A, Jenkins N P, Ewington I, Bridgewater B J M, Hooper T L, Greenhalgh D L, Patrick M R, Ray S G
Regional Cardiothoracic Unit, Wythenshawe Hospital, Manchester, UK.
Heart. 2004 Jul;90(7):771-6. doi: 10.1136/hrt.2003.013565.
Atrial en-face reconstructions are commonly used to assess mitral valve morphology in three dimensional (3D) echocardiography but may miss important abnormalities.
To present a systematic method for the analysis of the regurgitant mitral valve using a combination of en-face and longitudinal views for better anatomical evaluation.
Detailed 3D assessment was done on 58 patients undergoing mitral valve repair. En-face and longitudinal views were compared for detection and location of primary pathology. The quality of acquisitions under general anaesthesia and sedation was also compared.
Recognition of valve structure was significantly better with longitudinal reconstruction for both mitral leaflets but not for the commissures. Accurate identification of pathology was possible in 95% cases, compared with 50% for en-face reconstruction (p < 0.001). There was no significant difference between imaging under sedation and anaesthesia.
En-face reconstructions alone are inadequate. Additional longitudinal reconstructions are necessary to ensure full inspection of valve morphology.
在三维超声心动图中,心房正面重建常用于评估二尖瓣形态,但可能会遗漏重要异常。
提出一种系统方法,通过结合正面和纵向视图分析二尖瓣反流,以更好地进行解剖学评估。
对58例接受二尖瓣修复的患者进行详细的三维评估。比较正面和纵向视图以检测和定位主要病变。还比较了全身麻醉和镇静状态下的采集质量。
对于两个二尖瓣叶,纵向重建对瓣膜结构的识别明显更好,但对于瓣叶联合处则不然。95%的病例能够准确识别病变,而正面重建的准确率为50%(p < 0.001)。镇静和麻醉状态下的成像无显著差异。
仅靠正面重建是不够的。需要额外的纵向重建以确保对瓣膜形态进行全面检查。