Grossmann G, Giesler M, Schmidt A, Kochs M, Wieshammer S, Eggeling T, Felder C, Hombach V
Department of Internal Medicine, University of Ulm, Germany.
Int J Cardiol. 1993 Dec 15;42(2):165-73. doi: 10.1016/0167-5273(93)90087-w.
In this study 97 patients with mitral regurgitation (age 62 +/- 11 years, 55 men, 42 women) quantified by angiography were studied using colour flow Doppler imaging of isovelocity surface areas in the flow convergence region proximal to the regurgitant orifice. The radii of the proximal isovelocity surface areas for the flow velocities of 28 and 41 cm/s were measured. A flow convergence region was imaged in 100% (96%) of the patients with Grade I/II or more and in 92% (64%) of the patients with Grade I mitral regurgitation for a flow velocity of 28 (41) cm/s. The radii of the proximal isovelocity surface areas correlated significantly with the angiographic grade in patients with sinus rhythm as well as atrial fibrillation. A correct differentiation of Grade I to II from Grade III to IV mitral regurgitation was provided in more than 90% of all patients for both flow velocities investigated. Assuming hemispheric proximal isovelocity surface areas, in 11 patients the regurgitant volumes from echocardiography (range: 2.6-241 (0.9-198) ml for a flow velocity = 28 (41) cm/s) correlated with, but considerably overestimated the values from cardiac catheterization (range: 1.4-72.5 ml) with r = 0.79 (0.82) (P < 0.01) and SEE = 57.9 (42.4) ml for a flow velocity of 28 (41) cm/s. It was concluded that colour flow Doppler imaging of the flow convergence region enables the diagnosis of mitral regurgitation and the differentiation between Grade I to II and Grade III to IV mitral regurgitation, but may be of little value in estimating the regurgitant volume, assuming a hemispheric symmetry of the proximal flow convergence region.
在本研究中，我们对97例经血管造影定量的二尖瓣反流患者（年龄62±11岁，男性55例，女性42例），使用反流口近端血流汇聚区等速表面面积的彩色多普勒成像进行研究。测量了流速为28和41 cm/s时近端等速表面面积的半径。对于流速为28（41）cm/s的情况，I/II级及以上二尖瓣反流患者中100%（96%）可成像出血流汇聚区，I级二尖瓣反流患者中92%（64%）可成像出血流汇聚区。窦性心律以及心房颤动患者中，近端等速表面面积的半径与血管造影分级显著相关。对于所研究的两种流速，超过90%的患者能够正确区分I至II级与III至IV级二尖瓣反流。假设近端等速表面面积为半球形，11例患者经超声心动图测得的反流容积（流速为28（41）cm/s时范围为2.6 - 241（0.9 - 198）ml）与心导管检查测得的值相关，但显著高估了后者（范围为1.4 - 72.5 ml），流速为28（41）cm/s时r = 0.79（0.82）（P < 0.01），标准误为57.9（42.4）ml。研究得出结论，血流汇聚区的彩色多普勒成像能够诊断二尖瓣反流，并区分I至II级与III至IV级二尖瓣反流，但假设近端血流汇聚区为半球形对称时，在估计反流容积方面可能价值不大。
