Soliman Osama I I, Krenning Boudewijn J, Geleijnse Marcel L, Nemes Attila, van Geuns Robert-Jan, Baks Timo, Anwar Ashraf M, Galema Tjebbe W, Vletter Wim B, ten Cate Folkert J
Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Echocardiography. 2007 Oct;24(9):967-74. doi: 10.1111/j.1540-8175.2007.00502.x.
To compare the interobserver variability and accuracy of two different real time three-dimensional echocardiography (RT3DE) analyzing programs.
Forty-one patients (mean age 56 +/- 11 years, 28 men) in sinus rhythm with a cardiomyopathy and adequate 2D image quality underwent RT3DE and magnetic resonance imaging (MRI) within one day. Off-line left ventricular (LV) volume analysis was performed with QLAB V4.2 (semiautomated border detection with biplane projections) and TomTec 4D LV analysis V2.0 (primarily manual tracking with triplane projections and semiautomated border detection).
Excellent correlations (R(2) > 0.98) were found between MRI and RT3DE. Bland-Altman analysis revealed an underestimated LV end-diastolic volume (LV-EDV) for both TomTec (-9.4 +/- 8.7 mL) and QLAB (-16.4 +/- 13.1 ml). Also, an underestimated LV end-systolic volume (LV-ESV) for both TomTec (-4.8 +/- 9.9 mL) and QLAB (-8.5 +/- 14.2 mL) was found. LV-EDV and LV-ESV were significantly more underestimated with QLAB software. Both programs accurately calculated LV ejection fraction (LV-EF) without a bias. Interobserver variability was 6.4 +/- 7.8% vs. 12.2 +/- 10.1% for LV-EDV, 7.8 +/- 9.7% vs. 13.6 +/- 11.2% for LV-ESV, and 7.1 +/- 6.9% vs. 9.7 +/- 8.8% for LV-EF for TomTec vs. QLAB, respectively. The analysis time was shorter with QLAB (4 +/- 2 minutes vs. 6 +/- 2 minutes, P < 0.05).
RT3DE with TomTec or QLAB software analysis provides accurate LV-EF assessment in cardiomyopathic patients with distorted LV geometry and adequate 2D image quality. However, LV volumes may be somewhat more underestimated with the current QLAB software version.
比较两种不同的实时三维超声心动图（RT3DE）分析程序的观察者间变异性和准确性。
41例患有心肌病且二维图像质量良好的窦性心律患者（平均年龄56±11岁，28例男性）在一天内接受了RT3DE和磁共振成像（MRI）检查。使用QLAB V4.2（通过双平面投影进行半自动边界检测）和TomTec 4D LV分析V2.0（主要通过三平面投影进行手动追踪和半自动边界检测）进行离线左心室（LV）容积分析。
MRI与RT3DE之间发现了极好的相关性（R²>0.98）。Bland-Altman分析显示，TomTec（-9.4±8.7 mL）和QLAB（-16.4±13.1 ml）的左心室舒张末期容积（LV-EDV）均被低估。此外，还发现TomTec（-4.8±9.9 mL）和QLAB（-8.5±14.2 mL）的左心室收缩末期容积（LV-ESV）均被低估。使用QLAB软件时，LV-EDV和LV-ESV的低估更为明显。两个程序均能准确计算左心室射血分数（LV-EF）且无偏差。对于LV-EDV，TomTec与QLAB的观察者间变异性分别为6.4±7.8%和12.2±10.1%；对于LV-ESV，分别为7.8±9.7%和13.6±11.2%；对于LV-EF，分别为7.1±6.9%和9.7±8.8%。QLAB的分析时间更短（4±2分钟对6±2分钟，P<0.05）。
使用TomTec或QLAB软件分析的RT3DE可为左心室几何形状扭曲且二维图像质量良好的心肌病患者提供准确的LV-EF评估。然而，当前版本的QLAB软件可能会使LV容积的低估更为明显。
