Cand.med, Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
J Ultrasound Med. 2014 Feb;33(2):297-306. doi: 10.7863/ultra.33.2.297.
Transesophageal echocardiography has become a standard tool for evaluating left ventricular function during cardiac surgery. However, the image quality varies widely between patients and examinations. The aim of this study was to investigate the influence of the image quality on 5 commonly used 2-dimensional methods.
Transesophageal real-time 3-dimensional echocardiography (3DE) served as a reference. Left ventricular function was evaluated in 63 patients with sufficient real-time 3DE image quality. The image quality was rated using the ratio of the visualized border divided by the total endocardial border. These ratings were used to generate groups of poor (0%-40%), fair (41%-70%), and good (71%-100%) image quality. The ejection fraction (EF), end-diastolic volume, and end-systolic volume were analyzed by the Simpson method of disks (biplane and monoplane), eyeball method, Teichholz method, and speckle-tracking method. Furthermore, the fractional area change was determined. Each correlation with real-time 3DE was evaluated.
Correlations of the EF and volumes, respectively, as determined by long-axis view methods increased with improving image quality: the Simpson biplane method was found to be the most accurate method, with good image quality for the EF (r = 0.946) and volumes (end-diastolic volume, r = 0.962; end-systolic volume, r = 0.989). Correlations of the EF and fractional area change by short-axis view methods decreased with improving image quality, with the Teichholz EF found to be most accurate with poor (r = 0.928) in contrast to good (r = 0.699) image quality.
With good image quality, the Simpson biplane method is the most accurate 2-dimensional method for assessing the left ventricular EF. Short-axis view methods, especially the Teichholz method yield better correlations with poor image quality. The eyeball method was unaffected by image quality.
经食管超声心动图已成为心脏手术期间评估左心室功能的标准工具。然而，不同患者和检查之间的图像质量差异很大。本研究旨在探讨图像质量对 5 种常用 2 维方法的影响。
以实时经食管 3 维超声心动图（3DE）为参考。在 63 例实时 3DE 图像质量足够的患者中评估左心室功能。使用可视边界与总心内膜边界的比值对图像质量进行评分。这些评分用于生成图像质量差（0%-40%）、中等（41%-70%）和良好（71%-100%）的分组。采用双平面和单平面辛普森法、眼球法、Teichholz 法和斑点追踪法分析射血分数（EF）、舒张末期容积和收缩末期容积。此外，还确定了分数面积变化。分别评估与实时 3DE 的相关性。
长轴观方法的 EF 和容积相关性随图像质量的提高而增加：双平面辛普森法被认为是最准确的方法，EF（r=0.946）和容积（舒张末期容积，r=0.962；收缩末期容积，r=0.989）的图像质量良好。短轴观方法的 EF 和分数面积变化相关性随图像质量的提高而降低，Teichholz 法 EF 与较差（r=0.928）和较好（r=0.699）图像质量的相关性最好。
图像质量良好时，双平面辛普森法是评估左心室 EF 的最准确的 2 维方法。短轴观方法，尤其是 Teichholz 法，与较差的图像质量相关性更好。眼球法不受图像质量的影响。
