Siu S C, Levine R A, Rivera J M, Xie S W, Lethor J P, Handschumacher M D, Weyman A E, Picard M H
Cardiac Unit, Massachusetts General Hospital, Harvard Medical School, USA.
Am Heart J. 1995 Oct;130(4):812-22. doi: 10.1016/0002-8703(95)90082-9.
To calculate left ventricular (LV) volume by two-dimensional echocardiography (2DE), assumptions must be made about ventricular symmetry and geometry. Three-dimensional echocardiography (3DE) can quantitate LV volume without these limitations, yet its incremental value over 2DE is unknown. The purpose of this study was to compare the accuracy of LV volume determination by 3DE to standard 2DE methods. To compare the accuracy of 3DE with standard 2DE algorithms for quantitating LV volume, 28 excised canine ventricles of known volume and varying shapes (15 symmetric and 13 aneurysmal) and 10 instrumented dogs prepared so that instantaneous ventricular volume could be measured were examined by 2DE (bullet and biplane Simpson's formulas) and again by 3DE. In both excised and beating hearts, 3DE was more accurate in quantitating volume than either 2DE method (excised: error = 0.6 +/- 3.2, 2.5 +/- 10.7, and 4.0 +/- 8.5 ml by 3D, bullet, and Simpson's, respectively; beating: error = -0.5 +/- 3.5, -0.3 +/- 9.6, and -7.6 +/- 8.0 ml by 3DE, bullet, and Simpson's, respectively). This difference in accuracy between 3DE and 2DE methods was especially apparent in asymmetric ventricles distorted by ischemia or right ventricular volume overload. Stroke volume and ejection fraction calculated by 3DE also demonstrated better agreement with actual values than the bullet or Simpson methods with less variability (ejection fraction: error = -2.0% +/- 5.1%, 7.7% +/- 8.5%, and 6.8% +/- 12.3% by 3DE, bullet, and Simpson's, respectively). In both in vitro and in vivo settings, 3DE provides improved accuracy for LV volume and performance than current 2DE algorithms.
通过二维超声心动图（2DE）计算左心室（LV）容积时，必须对心室的对称性和几何形状做出假设。三维超声心动图（3DE）可以在没有这些限制的情况下定量LV容积，但其相对于2DE的增量价值尚不清楚。本研究的目的是比较3DE测定LV容积的准确性与标准2DE方法。为了比较3DE与标准2DE算法在定量LV容积方面的准确性，对28个已知容积且形状各异（15个对称的和13个动脉瘤样的）的切除犬心室以及10只经过仪器准备以便能够测量瞬时心室容积的犬进行了检查，先用2DE（子弹式和双平面辛普森公式）检查，然后再用3DE检查。在切除的心脏和跳动的心脏中，3DE在定量容积方面比任何一种2DE方法都更准确（切除的心脏：3D法、子弹式法和辛普森法的误差分别为0.6±3.2、2.5±10.7和4.0±8.5 ml；跳动的心脏：3DE法、子弹式法和辛普森法的误差分别为-0.5±3.5、-0.3±9.6和-7.6±8.0 ml）。3DE和2DE方法在准确性上的这种差异在因缺血或右心室容量超负荷而变形的不对称心室中尤为明显。通过3DE计算的每搏输出量和射血分数也比子弹式或辛普森法与实际值的一致性更好，变异性更小（射血分数：3DE法、子弹式法和辛普森法的误差分别为-2.0%±5.1%、7.7%±8.5%和6.8%±12.3%）。在体外和体内环境中，与当前的2DE算法相比，3DE在LV容积和功能的测定上都提供了更高的准确性。
