Wang Bing-Yan, Li Lian, Zhou Dan, Zhang Ming
Department of Ultrasound, The 2nd Xiangya Hospital of Central South University, Changsha, China.
Department of Ultrasound, Nanfang Hospital of Nanfang Medical University, Guangdong, China.
Echocardiography. 2019 Jul;36(7):1315-1321. doi: 10.1111/echo.14404. Epub 2019 Jun 27.
Recently, three-dimensional proximal isovelocity surface area (3D PISA) method has already been widely used in tricuspid regurgitation assessment. This study attempts to demonstrate the feasibility and accuracy of 3D PISA quantifying tricuspid regurgitation and explore the clinical value of 3D PISA in quantifying tricuspid regurgitation.
Fifty-four patients with more than mild tricuspid regurgitation (TR) were enrolled. Effective regurgitant orifice area (EROA) and regurgitant volume (Rvol) were assessed by transthoracic 3D PISA method and three-dimensional vena contracta area (3D VCA) method. The 3D VCA was used as reference method. We analyzed the correlation and differences of EROA between 3D PISA method and the reference method.
Both EROA and Rvol assessed by the 3D PISA had good correlations with the reference method, particularly in the assessment of eccentric jets, with the correlation coefficients of r (EROA) = 0.83, P < 0.001, r (Rvol) = 0.90, P < 0.001, respectively. 3D PISA method had good agreement with 3D VCA method in grading TR. Intra-observer and inter-observer agreement were also good.
Three-dimensional proximal isovelocity surface area method can accurately quantify the degree of tricuspid regurgitation with good repeatability and shorter time-consuming, which is worthy of further study. 3D PISA method is expected to be a new method for evaluating tricuspid regurgitation in clinic practice.
近年来，三维近端等速表面积（3D PISA）法已广泛应用于三尖瓣反流评估。本研究旨在论证3D PISA法量化三尖瓣反流的可行性和准确性，并探讨其在量化三尖瓣反流中的临床价值。
纳入54例中重度以上三尖瓣反流（TR）患者。采用经胸三维PISA法和三维缩流颈面积（3D VCA）法评估有效反流口面积（EROA）和反流容积（Rvol）。以3D VCA法作为参考方法。分析3D PISA法与参考方法之间EROA的相关性和差异。
3D PISA法评估的EROA和Rvol与参考方法均具有良好的相关性，尤其是在偏心反流束的评估中，相关系数分别为r（EROA） = 0.83，P < 0.001，r（Rvol） = 0.90，P < 0.001。3D PISA法在TR分级方面与3D VCA法具有良好的一致性。观察者内和观察者间的一致性也较好。
三维近端等速表面积法可准确量化三尖瓣反流程度，具有良好的重复性且耗时较短，值得进一步研究。3D PISA法有望成为临床实践中评估三尖瓣反流的一种新方法。
