Kwan Jun, Kim Gi-Chang, Jeon Min-Jae, Kim Dae-Hyeok, Shiota Takahiro, Thomas James D, Park Keum-Soo, Lee Woo-Hyung
Department of Cardiology, Inha University Hospital, 7-206, 3-Ga, Shinheung-Dong, Jung-Gu, Inchon 400-711, South Korea.
Eur J Echocardiogr. 2007 Oct;8(5):375-83. doi: 10.1016/j.euje.2006.07.010. Epub 2006 Sep 7.
This study was done to explore the 3D geometry of the normal tricuspid annulus and compare it with the mitral annulus (MA), using real-time 3D echocardiography (RT3DE) and newly developed 3D computer software.
Thirteen left ventricular (LV) and 13 right ventricular (RV) volumetric images were obtained using RT3DE from normal subjects. LV and RV volumetric data were segmented into 16 rotational apical planes (angle increment=11.25 degrees ) around the rotational axis from the apex through the center of two annuli, using newly developed 3D software (TomTec, Co., Munich, Germany). Two hinge points of the MA and the TA were traced in each plane during early and late systole. The MA and the TA were then automatically reconstructed with those 32 traced points. 3D surface (3DMAA, 3DTAA) and 2D projected areas (2DMAA, 2DTAA) of the annuli were calculated automatically as well, from those fitted data. For a comparison between the two annuli, the 3D and 2D area measurements of both annuli were corrected (c) according to the height of each patient (c2DMAA, c2DTAA, c3DMAA, and c3DTAA). Non-planarity of the annuli was estimated by their non-planar angles (MA: the angle between the anterior and posterior parts of the annulus; TA: the angle between the septal and free wall parts of the annulus).
The TA revealed a less non-planar saddle shape than did the MA, which had a significantly wider non-planar angle (167.7+/-3.2 vs 145.5+/-6.1 degrees , p<0.01) and a round or oval appearance on the projected view. The c2DTAA was significantly larger than the c2DMAA during early systole (p<0.01). However, there was no significant difference between the c3DTAA and c3DMAA during early and late systole (p>0.01).
We assessed the 3D geometry of the MA and the TA by 3D reconstruction using RT3DE and newly developed computer software. The TA had a less non-planar shape compared with the MA, with either a round or oval appearance on the projected view.
本研究旨在利用实时三维超声心动图（RT3DE）和新开发的三维计算机软件，探索正常三尖瓣环的三维几何形状，并与二尖瓣环（MA）进行比较。
使用RT3DE从正常受试者获取13个左心室（LV）和13个右心室（RV）容积图像。利用新开发的三维软件（德国慕尼黑TomTec公司），将LV和RV容积数据围绕从心尖穿过两个瓣环中心的旋转轴分割成16个旋转心尖平面（角度增量=11.25度）。在收缩早期和晚期，在每个平面上追踪MA和三尖瓣环（TA）的两个铰链点。然后用这32个追踪点自动重建MA和TA。还根据拟合数据自动计算瓣环的三维表面（3DMAA、3DTAA）和二维投影面积（2DMAA、2DTAA）。为了比较两个瓣环，根据每个患者的身高对两个瓣环的三维和二维面积测量值进行校正（c2DMAA、c2DTAA、c3DMAA和c3DTAA）。通过瓣环的非平面角估计瓣环的非平面性（MA：瓣环前后部分之间的角度；TA：瓣环间隔和游离壁部分之间的角度）。
与MA相比，TA的非平面马鞍形较小，MA的非平面角明显更宽（167.7±3.2度对145.5±6.1度，p<0.01），在投影视图上呈圆形或椭圆形。收缩早期，c2DTAA明显大于c2DMAA（p<0.01）。然而，收缩早期和晚期，c3DTAA和c3DMAA之间无显著差异（p>0.01）。
我们利用RT3DE和新开发的计算机软件通过三维重建评估了MA和TA的三维几何形状。与MA相比，TA的非平面形状较小，在投影视图上呈圆形或椭圆形。
