García-Orta Rocío, Moreno Eduardo, Vidal Matilde, Ruiz-López Fuensanta, Oyonarte José M, Lara Juan, Moreno Teodoro, García-Fernándezd Miguel A, Azpitarte José
Cardiology Department, University Hospital Virgen de las Nieves, Granada, Spain.
J Am Soc Echocardiogr. 2007 Jan;20(1):4-12. doi: 10.1016/j.echo.2006.07.005.
We sought to compare the diagnostic performance of 3-dimensional (3D) versus 2-dimensional (2D) echocardiography in patients with regurgitant mitral valve.
An accurate assessment of morphology and function of the mitral valve is essential for surgical repair. Two-dimensional echocardiography has certain spatial limitations that could be overcome by 3D imaging.
Preoperative transesophageal 2D and 3D studies were compared with surgical findings in patients undergoing surgical repair for severe mitral regurgitation.
A total of 81 consecutive patients underwent surgical repair (2002-2004). There was a high concordance (88%-100%) between both 2D and 3D studies and surgical findings in classification of involved segments. 3D imaging more accurately classified A1 segment defects (P = .05) and commissural dysfunction (P = .02). The 2D study incorrectly classified 22 segments, mainly corresponding to complex disease. The 3D study incorrectly classified 14 segments, unrelated to complex disease. Good agreement (94%, kappa 0.845) was found between non-expert and expert interpretations of 3D images.
Three-dimensional echocardiography offers high accuracy in mitral valve evaluation. It may complement 2D study in patients with complex valve anatomy, where surgical decisions are more difficult. The images can be easily interpreted by professionals without a high degree of experience.
我们旨在比较三维（3D）与二维（2D）超声心动图对二尖瓣反流患者的诊断性能。
准确评估二尖瓣的形态和功能对于手术修复至关重要。二维超声心动图存在一定的空间局限性，而三维成像可以克服这些局限性。
对接受严重二尖瓣反流手术修复的患者，将术前经食管二维和三维研究结果与手术发现进行比较。
共有81例连续患者接受了手术修复（2002 - 2004年）。在受累节段的分类中，二维和三维研究与手术发现之间存在高度一致性（88% - 100%）。三维成像能更准确地对A1节段缺损（P = 0.05）和瓣叶交界处功能障碍（P = 0.02）进行分类。二维研究错误分类了22个节段，主要对应复杂病变。三维研究错误分类了14个节段，与复杂病变无关。非专家和专家对三维图像的解读之间具有良好的一致性（94%，kappa值0.845）。
三维超声心动图在二尖瓣评估中具有高度准确性。在瓣膜解剖结构复杂、手术决策更困难的患者中，它可能补充二维研究。这些图像可以被经验不太丰富的专业人员轻松解读。
