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[实时三维全容积数据集:聚焦问题的术中经食管超声心动图的优势]

[Real-time 3 dimensional full volume data set : benefits in problem focused intraoperative transesophageal echocardiography].

作者信息

Ender A, Eibel S, Hasheminejad E, Scholz M, Kaisers U X, Mukherjee C, Ender J

机构信息

Abteilung für Anästhesiologie und Intensivmedizin II, Herzzentrum, Universität Leipzig, Strümpellstr. 39, 04289, Leipzig, Deutschland.

出版信息

Anaesthesist. 2012 Oct;61(10):875-82. doi: 10.1007/s00101-012-2088-z. Epub 2012 Oct 20.

Abstract

BACKGROUND

Comprehensive intraoperative transesophageal echcardiography (TEE) includes various measurements for quantification of cardiac chambers and valves based on multiple two dimensional (2D) standard views. Due to shortness of time during cardiac surgery most centres in Germany only carry out problem focussed intraoperative examinations which does not allow the complete repertoire of measurements to be exhausted. The aim of this study was to investigate which measurements for cardiac chamber and valve quantification can be performed with the acquisition of a real-time 3D full volume (RT-3D-FV) data set and to compare these measurements with those based on standard 2D views.

MATERIALS AND METHODS

In patients undergoing elective surgical mitral valve repair a comprehensive 2D TEE examination according to the guidelines of the American Society of Echocardiography (ASE) and the Society of Cardiovascular Anesthesiologists (SCA) was performed after induction of anesthesia. Additionally, a RT-3D-FV TEE data set based on the midesophageal four chamber view was recorded (iE 33, Philips, Netherlands). All measurements of the 2D TEE and the RT-3D-FV dataset (Qlab) were performed offline by two independent examiners.

RESULTS

After approval by the local ethic committee and obtaining written informed consent 50 patients (31 male and 19 female) with a mean age of 59.4 ± 11.5 years were enrolled in this study. All measurements recommended for chamber and valve quantification could be performed on the basis of the RT-3D-FV data set except for measurements of the sinus of Valsalva and the sinotubular junction. There was good correlation between the results of the two methods.

CONCLUSIONS

For intraoperative problem focussed TEE examinations the acquisition of an additional RT-3D-FV TEE data set allows accurate measurement of most of the recommended chamber and valve quantification parameters.

摘要

背景

综合性术中经食管超声心动图(TEE)包括基于多个二维(2D)标准视图对心腔和瓣膜进行量化的各种测量。由于心脏手术期间时间紧迫,德国的大多数中心仅进行针对问题的术中检查,这无法穷尽所有测量项目。本研究的目的是调查通过获取实时三维全容积(RT-3D-FV)数据集可进行哪些心腔和瓣膜量化测量,并将这些测量结果与基于标准二维视图的测量结果进行比较。

材料与方法

对择期进行二尖瓣修复手术的患者,在麻醉诱导后按照美国超声心动图学会(ASE)和心血管麻醉医师学会(SCA)的指南进行全面的二维TEE检查。此外,记录基于食管中段四腔心视图的RT-3D-FV TEE数据集(iE 33,飞利浦,荷兰)。二维TEE和RT-3D-FV数据集(Qlab)的所有测量均由两名独立检查人员离线进行。

结果

经当地伦理委员会批准并获得书面知情同意后,本研究纳入了50例患者(男性31例,女性19例),平均年龄为59.4±11.5岁。除了对主动脉瓣窦和窦管交界的测量外,基于RT-3D-FV数据集可进行所有推荐的心腔和瓣膜量化测量。两种方法的结果之间存在良好的相关性。

结论

对于术中针对问题的TEE检查,额外获取RT-3D-FV TEE数据集能够准确测量大多数推荐的心腔和瓣膜量化参数。

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