Becher H, Mintert C, Grube E, Lüderitz B
Medizinische Universitäts-Poliklinik, Bonn.
Z Kardiol. 1989 Dec;78(12):764-70.
To evaluate different methods for quantification, 55 adult patients with mitral insufficiency were investigated by Doppler color flow mapping (CFM). The maximal area, length and width of the regurgitant jet were determined using apical windows and these were then related to the angiographic findings (Sellers I-IV). In 11/55 patients reliable tracing of the regurgitant flow was not possible because of drop-outs and impaired signal-to-noise ratio. With none of the three systems was a reliable differentiation of moderate to severe forms of mitral incompetence possible because of wide overlapping of the CFM-values in the four angiographic classes. Relating the CFM-values to the diameter or area of the left atrium did not improve the correlations with the angiographic data. At best, the measurement of the maximal area allowed an approximate estimation of the degree of insufficiency: values greater than 6.5 cm2 were not found in patients with Sellers class I or II. Results below this limit could be found in all four angiographic classes. The variability for the estimation of the maximum area (linear regression analysis) was r = 0.96, SEE = 0.07 (intraobserver) and r = 0.94, SEE = 0.08 (interobserver).
CFM is not a reliable method for classification of mitral regurgitation.
为评估不同的定量方法,对55例二尖瓣关闭不全的成年患者进行了多普勒彩色血流图(CFM)检查。使用心尖窗确定反流束的最大面积、长度和宽度,然后将这些参数与血管造影结果(Sellers I-IV级)进行关联。在55例患者中,有11例由于信号丢失和信噪比受损而无法可靠地追踪反流血流。由于四个血管造影级别中CFM值广泛重叠,三种系统中的任何一种都无法可靠地区分中度至重度二尖瓣关闭不全。将CFM值与左心房直径或面积相关联并不能改善与血管造影数据的相关性。充其量,最大面积的测量只能大致估计反流程度:Sellers I级或II级患者中未发现面积大于6.5 cm² 的情况。在所有四个血管造影级别中都可发现低于此限值的结果。估计最大面积的变异性(线性回归分析)为观察者内r = 0.96,SEE = 0.07,观察者间r = 0.94,SEE = 0.08。
CFM不是二尖瓣反流分级的可靠方法。