Niemann Petra S, Pinho Luiz, Balbach Thomas, Galuschky Christian, Blankenhagen Michael, Silberbach Michael, Broberg Craig, Jerosch-Herold Michael, Sahn David J
Oregon Health & Science University, Portland, Oregon 97239-3098, USA.
J Am Coll Cardiol. 2007 Oct 23;50(17):1668-76. doi: 10.1016/j.jacc.2007.07.031.
We tested a newly developed 4-dimensional (4D) right ventricular (RV) analysis method for computing RV volumes for both 3-dimensional (3D) ultrasound (US) and magnetic resonance (MR) images.
Asymmetry and the anatomical complexity of the RV make accurate determination of RV shape and volume difficult.
Thirty patients, 14 with grossly normal cardiac anatomy and 16 with major congenital heart disease, were studied at the same visit with both 3D echocardiography (echo) and magnetic resonance imaging (MRI) for RV size and function. Ultrasound images were acquired on a Philips 7500 system (Philips Medical Systems, Andover, Massachusetts) with a matrix-array transducer (real-time 3D echo) with full volume sweeps from apical and subcostal views. Sagittal, 4-chamber, and coronal views were derived for contour detection (all 12 to 24 slices). The MR images were acquired with a 3-T MRI magnet with segmented cine-loop gradient echo sequences in short- and rotated long-axis views to cover the RV inflow, body, and outflow tract. The RV volumes were analyzed with the new software applicable to 3D echo MR images.
New software aided delineation of the RV free wall, tricuspid valve, RV outflow tract, and apex on 3D echo volumes. Although there was a slightly higher variability measuring right ventricular ejection fraction (RVEF) and volumes obtained by US compared with MRI, both imaging methods showed closely correlated results. The RVEF was measured with 4% variability for US and 5% variability for MRI with a correlation coefficient of r = 0.91. The RV end-diastolic volume was measured at 70.97 +/- 15.0 ml with 3D US and at 70.06 +/- 14.8 ml with MRI (r = 0.99), end-systolic volume measured 39.8 +/- 10.4 ml with 3D US and 39.1 +/- 10.2 ml with MRI (r = 0.98).
The new RV analysis software allowed validation of the accuracy of 4D echo RV volume data compared with MRI.
我们测试了一种新开发的四维（4D）右心室（RV）分析方法，用于计算三维（3D）超声（US）和磁共振（MR）图像中的RV容积。
RV的不对称性和解剖复杂性使得准确确定RV的形状和容积变得困难。
对30例患者进行了研究，其中14例心脏解剖结构大致正常，16例患有主要先天性心脏病，在同一次就诊时同时接受了三维超声心动图（超声）和磁共振成像（MRI）检查，以评估RV大小和功能。超声图像通过飞利浦7500系统（飞利浦医疗系统公司，马萨诸塞州安多弗）采集，使用矩阵阵列换能器（实时三维超声），从心尖和肋下视图进行全容积扫描。获取矢状面、四腔心和冠状面视图用于轮廓检测（共12至24层）。MR图像通过3-T MRI磁体采集，采用分段电影环梯度回波序列，在短轴和旋转长轴视图中覆盖RV流入道、体部和流出道。使用适用于3D超声和MR图像的新软件分析RV容积。
新软件有助于在三维超声容积上描绘RV游离壁、三尖瓣、RV流出道和心尖。尽管与MRI相比，通过超声测量右心室射血分数（RVEF）和容积的变异性略高，但两种成像方法的结果显示出密切的相关性。超声测量RVEF的变异性为4%，MRI为5%，相关系数r = 0.91。三维超声测量RV舒张末期容积为70.97±15.0 ml，MRI为70.06±14.8 ml（r = 0.99）；收缩末期容积三维超声测量为39.8±10.4 ml，MRI为39.1±10.2 ml（r = 0.98）。
与MRI相比，新的RV分析软件验证了4D超声RV容积数据的准确性。
