Wilson G M, Rahko P S
Department of Medicine, University of Wisconsin Medical School, Madison, USA.
J Am Soc Echocardiogr. 1995 Nov-Dec;8(6):822-9. doi: 10.1016/s0894-7317(05)80006-9.
The aim of this study was to compare measurements of echocardiographic volume with an on-line automatic boundary detection imaging system with those of a conventional off-line method for routine clinical studies. Automatic boundary detection imaging shows promise as a rapid, on-line method for quantitating left ventricular volumes by echocardiography. However, there is little information about the role of automatic boundary detection for routine clinical studies. Ninety-seven patients with a variety of clinical diseases who were referred for clinical transthoracic echocardiographic evaluation were studied in apical four-chamber and two-chamber imaging planes. End-diastolic volume, end-systolic volume, and ejection fraction obtained with automatic boundary detection images were compared with those of conventional off-line analysis. Segmental endocardial definition and border tracking were evaluated on all automatic boundary detection images. Left ventricular end-diastolic volumes obtained by automatic boundary detection correlated well but were systematically under-estimated compared with off-line analysis for the apical two-chamber (r = 0.83; underestimation = 42 +/- 33 ml; p < 0.05) and four-chamber views (r = 0.83; underestimation = 43 +/- 31 ml; p < 0.05). Left ventricular end-systolic volumes also correlated well but were underestimated by automatic boundary detection for the apical two-chamber (r = 0.83; underestimation = 14 +/- 26 ml; p < 0.05) and four-chamber views (r = 0.83; underestimation = 18 +/- 24 ml; p < 0.05). Ejection fraction was not predicted accurately for the entire study population (n = 97). However, for patients with complete endocardial definition (n = 32), automatic boundary detection accurately predicted ejection fraction with no systematic error compared with manually traced images for both the apical two-chamber (r = 0.86; p < 0.05) and four-chamber (r = 0.82; p < 0.05) views. Segmental analysis of endocardial tracking revealed significantly better tracking of the septal and lateral walls compared with other regions (p < 0.05). End-diastolic and end-systolic volumes determined by automatic boundary detection correlate well but underestimate volume compared with conventional off-line analysis. However, ejection fraction compares favorably for the two methods when there is complete endocardial definition.
本研究的目的是将在线自动边界检测成像系统对超声心动图容积的测量结果与常规离线方法在常规临床研究中的测量结果进行比较。自动边界检测成像有望成为一种通过超声心动图快速在线定量左心室容积的方法。然而，关于自动边界检测在常规临床研究中的作用，相关信息较少。对97例因各种临床疾病前来接受经胸超声心动图临床评估的患者，在心尖四腔心和两腔心成像平面进行了研究。将自动边界检测图像获得的舒张末期容积、收缩末期容积和射血分数与传统离线分析的结果进行比较。对所有自动边界检测图像评估节段性心内膜清晰度和边界追踪情况。自动边界检测获得的左心室舒张末期容积与离线分析结果相关性良好，但与心尖两腔心（r = 0.83；低估 = 42±33 ml；p < 0.05）和四腔心视图（r = 0.83；低估 = 43±31 ml；p < 0.05）相比，系统性低估。左心室收缩末期容积相关性也良好，但自动边界检测对心尖两腔心（r = 0.83；低估 = 14±26 ml；p < 0.05）和四腔心视图（r = 0.83；低估 = 18±24 ml；p < 0.05）存在低估。对于整个研究人群（n = 97），射血分数预测不准确。然而，对于心内膜清晰度完整的患者（n = 32），与手动追踪图像相比，自动边界检测在预测射血分数方面无系统误差，在心尖两腔心（r = 0.86；p < 0.05）和四腔心（r = 0.82；p < 0.05）视图中均如此。心内膜追踪的节段性分析显示，与其他区域相比，室间隔和侧壁的追踪明显更好（p < 0.05）。自动边界检测确定的舒张末期和收缩末期容积相关性良好，但与传统离线分析相比，容积低估。然而，当存在完整的心内膜清晰度时，两种方法的射血分数比较结果较好。
