Oregon Health and Science University, Portland, USA.
Am J Cardiol. 2010 Nov 1;106(9):1345-50. doi: 10.1016/j.amjcard.2010.06.065.
Increased atrial volumes predict adverse cardiovascular events. Accordingly, accurate measurement of atrial size has become increasingly important in clinical practice. The area-length method is commonly used to estimate the volume. Disagreements between atrial volumes using echocardiography and other imaging modalities have been found. It is unclear whether this has resulted from differences in the measurement method or discrepancies among imaging modalities. We compared the right atrial (RA) and left atrial (LA) volume estimates using the area-length method for transthoracic echocardiography and cardiovascular magnetic resonance (CMR) imaging. Patients undergoing echocardiography and CMR imaging within 1 month were identified retrospectively. For both modalities, the RA and LA long-axis dimension and area were measured using standard 2- and 4-chamber views, and the volume was calculated using the area-length method for both atria. The echocardiographic and CMR values were compared using the Bland-Altman method. A total of 85 patients and 18 controls were included in the present study. The atrial volumes estimated using the area-length method were significantly smaller when measured using echocardiography than when measured using CMR imaging (LA volume 35 ± 20 vs 49 ± 30 ml/m², p <0.001, and RA volume 32 ± 23 vs 43 ± 29 ml/m², p = 0.012). The mean difference (CMR imaging minus echocardiography) was 14 ± 14 ml/m² for the LA and 10 ± 16 ml/m² for the RA volume. Similar results were found in the healthy controls. No significant intra- or interobserver variability was found within each modality. In conclusion, echocardiography consistently underestimated the atrial volumes compared to CMR imaging using the area-length method.
心房容积增大预示心血管不良事件。因此，准确测量心房大小在临床实践中变得越来越重要。面积-长度法常用于估计容积。已经发现，超声心动图和其他成像方式测量的心房容积存在差异。尚不清楚这是由于测量方法的差异还是成像方式的差异所致。我们比较了经胸超声心动图和心血管磁共振（CMR）成像的面积-长度法测量的右心房（RA）和左心房（LA）容积估计值。回顾性地确定了在 1 个月内接受超声心动图和 CMR 成像的患者。对于两种模式，均使用标准的 2 腔和 4 腔视图测量 RA 和 LA 长轴尺寸和面积，并使用面积-长度法计算两个心房的容积。使用 Bland-Altman 方法比较超声心动图和 CMR 值。本研究共纳入 85 例患者和 18 例对照。使用超声心动图测量时，心房容积（LA 容积 35 ± 20 比 49 ± 30 ml/m²，p <0.001，RA 容积 32 ± 23 比 43 ± 29 ml/m²，p = 0.012）明显小于 CMR 成像测量值。LA 和 RA 容积的平均差值（CMR 成像减去超声心动图）分别为 14 ± 14 ml/m²和 10 ± 16 ml/m²。在健康对照组中也发现了类似的结果。在每种模式下，均未发现观察者内或观察者间的明显变异性。总之，与 CMR 成像相比，面积-长度法的超声心动图始终低估了心房容积。
