Habeeb Nevin Mohamed, Youssef Omneya Ibrahim, Elguindy Waleed Mohamed, Ibrahim Ahmed Samir, Hussein Walaa Hamed
Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Open Access Maced J Med Sci. 2018 Oct 25;6(12):2310-2315. doi: 10.3889/oamjms.2018.270. eCollection 2018 Dec 20.
Left ventricular (LV) volumes and ejection fraction (EF) is Strong prognostic indicators for DCM. Cardiac MRI (CMRI) is a preferred technique for LV volumes and EF assessment due to high spatial resolution and complete volumetric datasets. Three-dimensional echocardiography is a promising new technique under investigations.
Evaluate 3D echocardiography as a tool in LV assessment in DCM children about CMRI.
A group of 20 DCM children (LVdiastolic diameter < 2 Z score, LVEF < 35%) at Children s Hospital, Ain-Shams University (gp1) (mean age 6.6 years) were compared to 20 age and sex-matched children as controls (gp2). Patients were subjected to: clinical examination, conventional echocardiography, automated 3D LV quantification, 3D speckle tracking echocardiography (3D-STE) (VIVID E9 Vingmed, Norway) and CMRI (Philips Achieva Nova, 1.5 Tesla scanner) for LV end systolic volume (LVESV), LVend diastolic volume (LVEDV) that were indexed to body surface area, EF% and wall motion abnormalities assessment.
No statistically significant difference was found between automated 3D LV quantification echocardiography, 3D-STE, and CMRI in ESV/BSA and EDV/BSA assessment (p = 1, 0.99 respectively), between automated LV quantification echocardiography and CMRI in EF% assessment (p = 0.99) and between CMRI and 3D-STE in LV Global hypokinesia detection (P = 0.255). As for segmental hypokinesia CMRI was more sensitive [45% of patients vs. 40%, (P = 0,036), basal septal hypokinesia 85% vs. 75%, (p = 0.045), mid septal hypokinesia 80% vs. 65%, (p = 0.012) and lateral wall hypokinesia 75% vs. 65%, (p = 0.028)].
Automated 3D LV quantification echocardiography and 3D-STE are reliable tools in LV volumetric and systolic function assessment about CMRIas a standard method. 3D speckle echocardiography is comparable to CMRI in global wall hypokinesia detection but less sensitive in segmental wall hypokinesia which mandates further studies.
左心室（LV）容积和射血分数（EF）是扩张型心肌病（DCM）强有力的预后指标。心脏磁共振成像（CMRI）由于具有高空间分辨率和完整的容积数据集，是评估LV容积和EF的首选技术。三维超声心动图是一项正在研究中的有前景的新技术。
评估三维超声心动图作为一种工具，用于在DCM患儿中评估LV，与CMRI进行比较。
将开罗艾因夏姆斯大学儿童医院的一组20例DCM患儿（LV舒张末期直径<2 Z评分，LVEF<35%）（第1组）（平均年龄6.6岁）与20例年龄和性别匹配的儿童作为对照组（第2组）进行比较。患者接受了：临床检查、常规超声心动图、自动三维LV定量、三维斑点追踪超声心动图（3D-STE）（挪威VIVID E9 Vingmed）和CMRI（飞利浦Achieva Nova，1.5特斯拉扫描仪），以评估LV收缩末期容积（LVESV）、LV舒张末期容积（LVEDV），这些容积已根据体表面积进行指数化，评估EF%和室壁运动异常。
在ESV/BSA和EDV/BSA评估中，自动三维LV定量超声心动图、3D-STE和CMRI之间未发现统计学显著差异（p分别为1、0.99）；在EF%评估中，自动LV定量超声心动图和CMRI之间未发现统计学显著差异（p = 0.99）；在LV整体运动减弱检测中，CMRI和3D-STE之间未发现统计学显著差异（P = 0.255）。至于节段性运动减弱，CMRI更敏感[45%的患者对40%，（P = 0.036），基底间隔运动减弱85%对75%，（p = 0.045），中间隔运动减弱80%对65%，（p = 0.012），侧壁运动减弱75%对65%，（p = 0.028）]。
自动三维LV定量超声心动图和3D-STE是在LV容积和收缩功能评估中与作为标准方法的CMRI相当的可靠工具。三维斑点超声心动图在整体室壁运动减弱检测方面与CMRI相当，但在节段性室壁运动减弱方面敏感性较低，这需要进一步研究。
