De Potter Tom, Weytjens Caroline, Motoc Andreea, Luchian Maria Luiza, Scheirlynck Esther, Roosens Bram, Tanaka Kaoru, Houard Laura, Droogmans Steven, Cosyns Bernard
Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.
Centrum Voor Hart-en Vaatziekten (CHVZ), Department of Cardiology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium.
Diagnostics (Basel). 2021 Apr 14;11(4):699. doi: 10.3390/diagnostics11040699.
Three-dimensional echocardiography (3DE) is advised for right ventricular (RV) assessment. Data regarding the optimal acquisition settings and optimization are still scarce. We aimed to evaluate the feasibility, reproducibility and validation of 3DE for RV volume and function assessment, using cardiac magnetic resonance (CMR) as gold standard. Thirty healthy volunteers and 36 consecutive patients were prospectively included. CMR was performed in the latter. Standard apical four-chamber view (A4CV), focused A4CV and modified A4CV were used for 3DE RV acquisition. Feasibility (and the effect of changes in settings) was evaluated. Intra and interobserver analyses were performed by three observers (expert vs. novice). RV parameters by echocardiography were compared to CMR. Feasibility of acquisition was 16.7% for A4CV, 80.0% for focused A4CV and 16.7% for modified A4CV. Changes in settings had no significant influence on feasibility and further analysis. Intraobserver variability was good in both expert and novice, interobserver variability was good between experienced observers. Compared to CMR, 3DE volumes were significantly lower with fair to moderate correlation (EDV: 91.1 ± 24.4 mL vs. 144.3 ± 43.0 mL ( < 0.001), r = 0.653 and ESV: 48.1 ± 16.4 mL vs. 60.4 ± 21.2 mL ( < 0.001), r = 0.530, by multi-beat 3DE and CMR respectively). These findings suggest that standardization is needed in order to implement this technique in clinical practice, thus further studies are required.
建议使用三维超声心动图（3DE）评估右心室（RV）。关于最佳采集设置和优化的数据仍然很少。我们旨在以心脏磁共振成像（CMR）作为金标准，评估3DE用于RV容积和功能评估的可行性、可重复性和有效性。前瞻性纳入了30名健康志愿者和36例连续患者。对后者进行了CMR检查。采用标准心尖四腔心切面（A4CV）、聚焦A4CV和改良A4CV进行3DE RV采集。评估了可行性（以及设置变化的影响）。由三名观察者（专家与新手）进行观察者内和观察者间分析。将超声心动图测得的RV参数与CMR结果进行比较。A4CV的采集可行性为16.7%，聚焦A4CV为80.0%，改良A4CV为16.7%。设置变化对可行性和进一步分析无显著影响。专家和新手的观察者内变异性均良好，经验丰富的观察者之间的观察者间变异性也良好。与CMR相比，3DE测得的容积显著更低，相关性为中等至良好（分别通过多博动3DE和CMR测量，舒张末期容积：91.1±24.4 mL对144.3±43.0 mL（<0.001），r = 0.653；收缩末期容积：48.1±16.4 mL对60.4±21.2 mL（<0.001），r = 0.530）。这些发现表明，为了在临床实践中应用该技术，需要进行标准化，因此还需要进一步研究。
