左心室容积的对比增强与非增强三维超声心动图。
Contrast-enhanced versus non-enhanced three-dimensional echocardiography of left ventricular volumes.
机构信息
Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands.
出版信息
Neth Heart J. 2008 Feb;16(2):47-52. doi: 10.1007/BF03086117.
BACKGROUND
In three-dimensional echocardiography (3DE), individual endocardial trabeculae are not clearly visible necessitating left ventricular (LV) volumes to be measured by tracing the innermost endocardial contour. Ultrasound contrast agents aim to improve endocardial definition, but may delineate the outermost endocardial contour by filling up intertrabecular space. Although measurement reproducibility may benefit, there may be a significant influence on absolute LV volume measurements.
METHODS
Twenty patients with a recent myocardial infarction and good ultrasound image quality underwent 3DE using the TomTec Freehand method before and during continuous intravenous contrast infusion. LV volumes were measured offline using TomTec Echo-Scan software.
RESULTS
The use of contrast enhancement increased end-diastolic (110+/-35 vs. 144+/-53 ml; p<0.01) and end-systolic volume measurements (68+/-31 vs. 87+/-45 ml; p<0.01) significantly compared with non-contrast; the ejection fraction remained unchanged (40+/-13 vs. 41+/-14%, p=NS). Measurement reproducibility did not improve significantly, however.
CONCLUSION
Volumes measured by 3DE are significantly larger when ultrasound contrast is used. Possibly, intertrabecular space comprises a substantial part of the LV cavity. In the presence of an adequate apical acoustic window, ultrasound contrast does not improve LV volume measurement reproducibility. (Neth Heart J 2008;16:47-52.).
背景
在三维超声心动图（3DE）中，单个心内膜小梁不太清晰，因此需要通过追踪内心膜轮廓来测量左心室（LV）容积。超声对比剂旨在改善内心膜的清晰度，但可能通过填充心内膜小梁间隙来描绘最外面的心内膜轮廓。尽管测量的可重复性可能会受益，但可能会对绝对 LV 容积测量产生重大影响。
方法
20 例近期心肌梗死且超声图像质量良好的患者使用 TomTec Freehand 方法进行 3DE，在连续静脉内对比剂输注前后进行。使用 TomTec Echo-Scan 软件离线测量 LV 容积。
结果
与非对比剂相比，使用对比增强显著增加了舒张末期（110+/-35 比 144+/-53 ml；p<0.01）和收缩末期容积测量值（68+/-31 比 87+/-45 ml；p<0.01）；射血分数保持不变（40+/-13 比 41+/-14%，p=NS）。然而，测量的可重复性并没有显著提高。
结论
当使用超声对比剂时，通过 3DE 测量的容积明显更大。可能是心内膜小梁间隙构成 LV 腔的一个重要部分。在具有足够的心尖声学窗的情况下，超声对比剂不会提高 LV 容积测量的可重复性。（Neth Heart J 2008;16:47-52.）。
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