Gopal A S, Schnellbaecher M J, Shen Z, Akinboboye O O, Sapin P M, King D L
Cardiovascular Institute, Mount Sinai Medical Center, New York, New York, USA.
J Am Coll Cardiol. 1997 Sep;30(3):802-10. doi: 10.1016/s0735-1097(97)00198-8.
We sought to validate freehand three-dimensional echocardiography for measuring left ventricular mass and to compare its accuracy and variability with those of conventional echocardiographic methods.
Accurate measurement of left ventricular mass is clinically important as a predictor of morbidity and mortality. Freehand three-dimensional echocardiography eliminates geometric assumptions used by conventional methods, minimizes image positioning errors using a line of intersection display and increases sampling of the ventricle. Preliminary studies have shown it to have high accuracy and low variability.
Twenty-eight patients awaiting heart transplantation were examined by conventional and freehand three-dimensional echocardiography. Left ventricular mass was determined by the M-mode ("Penn-cube") method, the two-dimensional truncated ellipsoid method and three-dimensional surface reconstruction. The ventricles of 20 explanted hearts were obtained, trimmed and weighed. Echocardiographic mass by each method was compared with true mass by linear regression. Accuracy, bias and interobserver variability were calculated.
For three-dimensional echocardiography, the correlation coefficient, standard error of the estimate, root mean square percent error (accuracy), bias and interobserver variability were 0.992, 11.9 g, 4.8%, -4.9 g and 11.5%, respectively. For the two-dimensional truncated ellipsoid method they were 0.905, 38.5 g, 15.6%, 15.4 g and 23.3%. For the M-mode ("Penn-cube") method they were 0.721, 96.9 g, 53.0%, 109.2 g and 19.5%.
Freehand three-dimensional echocardiography for measurement of left ventricular mass has high accuracy and low variability and is superior to conventional methods in hearts of abnormal size and geometry.
我们试图验证徒手三维超声心动图测量左心室质量的方法，并将其准确性和变异性与传统超声心动图方法进行比较。
准确测量左心室质量作为发病率和死亡率的预测指标在临床上具有重要意义。徒手三维超声心动图消除了传统方法所采用的几何假设，利用交线显示将图像定位误差降至最低，并增加了对心室的采样。初步研究表明其具有高准确性和低变异性。
对28例等待心脏移植的患者进行传统和徒手三维超声心动图检查。左心室质量通过M型（“宾夕法尼亚立方”）法、二维截断椭球体法和三维表面重建法测定。获取20颗离体心脏的心室，修剪并称重。将每种方法测得的超声心动图质量与实际质量进行线性回归比较。计算准确性、偏差和观察者间变异性。
对于三维超声心动图，相关系数、估计标准误差、均方根百分比误差（准确性）、偏差和观察者间变异性分别为0.992、11.9 g、4.8%、-4.9 g和11.5%。对于二维截断椭球体法，它们分别为0.905、38.5 g、15.6%、15.4 g和23.3%。对于M型（“宾夕法尼亚立方”）法，它们分别为0.721、96.9 g、53.0%、109.2 g和19.5%。
徒手三维超声心动图测量左心室质量具有高准确性和低变异性，在大小和几何形状异常的心脏中优于传统方法。
