Anwar Ashraf M, Geleijnse Marcel L, Ten Cate Folkert J, Meijboom Folkert J
Thoraxcenter, Room Ba 302, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Interact Cardiovasc Thorac Surg. 2006 Dec;5(6):683-7. doi: 10.1510/icvts.2006.132381. Epub 2006 Aug 2.
Tricuspid annulus (TA) evaluation continues to be a major problem in the surgical decision-making process. Obviously, 2-dimensional transthoracic echocardiography (2D TTE) is limited in TA visualization due to its complex 3D shape. The study aimed to determine TA morphology, size and function with real-time three-dimensional echocardiography (RT3DE) in 40 patients divided into two equal groups (I: normal TA and II: dilated). 2D TTE measurements included TA diameter (TAD) at apical 4-chamber (AP4CH) and parasternal short axis (PSAX) views. RT3DE measurements included TA area (TAA), major TAD and minor TAD. TA fractional shortening (TAFS), and TA fractional area change (TAFAC) were calculated from end-systolic and end-diastolic measurements. RT3DE allowed visualization and measurement of the entire oval-shaped TA in all patients irrespective of its size (normal or dilated). 2D TTE measurement of TAD at both AP4CH and at PSAX views was significantly smaller than the major TAD measured by RT3DE (P<0.0001) and nearly matched with the minor TAD in all patients. Calculation of TAFS was comparable with both techniques. TAFAC was significantly higher than TAFS (P<0.0001). So, RT3DE could be relied on more accurately than 2D TTE in the assessment of TA size and function which may aid in decision-making and selection of proper surgical procedure when indicated.
三尖瓣环（TA）评估一直是手术决策过程中的一个主要问题。显然，二维经胸超声心动图（2D TTE）由于TA复杂的三维形状，在TA可视化方面存在局限性。本研究旨在利用实时三维超声心动图（RT3DE）确定40例患者的TA形态、大小和功能，这些患者被分为两组，每组20例（I组：正常TA；II组：扩张型TA）。2D TTE测量包括心尖四腔心（AP4CH）和胸骨旁短轴（PSAX）视图下的TA直径（TAD）。RT3DE测量包括TA面积（TAA）、主要TAD和次要TAD。TA缩短分数（TAFS）和TA面积变化分数（TAFAC）由收缩末期和舒张末期测量值计算得出。RT3DE能够在所有患者中可视化并测量整个椭圆形的TA，无论其大小（正常或扩张）。在AP4CH和PSAX视图下，2D TTE测量的TAD均显著小于RT3DE测量的主要TAD（P<0.0001），并且在所有患者中几乎与次要TAD匹配。两种技术计算出的TAFS具有可比性。TAFAC显著高于TAFS（P<0.0001）。因此，在评估TA大小和功能方面，RT3DE比2D TTE更可靠，这可能有助于在需要时进行决策和选择合适的手术方式。
