论文部分内容阅读
目的探讨二维(2DE)与实时三维超声心动图(RT-3DE)评价法乐氏四联症(TOF)患儿右室收缩功能指标的相关性。方法选择45例TOF患儿及46例正常同龄对照组作为研究对象,获取二维右室收缩功能指标:三尖瓣环侧壁收缩期位移距离(TAPSE),三尖瓣环侧壁收缩期峰值运动速度(TRV),右室心尖四腔观面积收缩率(RVa);应用RT-3DE于心尖偏胸骨旁四腔心采集右室全容积声像图,使用TomTec RV-Function软件分析右室射血分数(RVEF);对TOF组与正常对照组2DE及RT-3DE右室收缩功能指标进行比较并进行相关性分析。结果 TOF组RT-3DE获得的RVEF与2DE各右室收缩功能指标均小于正常对照组(P<0.05)。2DE各指标与RT-3DE获得的RVEF均呈正相关性(P<0.01),其中TAPSE与RVEF的相关性最好,r=0.574,P=0.000,ROC曲线分析表明TAPSE>1.68cm时,评价RVEF>45%的灵敏度为80%,特异度为78%(P=0.000)。结论 TOF患儿右室收缩功能减低,RT-3DE使快速无创评估右室射血分数成为可能。
Objective To investigate the correlation between two-dimensional (2DE) and right ventricular systolic function in children with tetralogy of Fallot (TOF) evaluated by real-time three-dimensional echocardiography (RT-3DE). Methods Forty-five children with TOF and 46 normal control subjects were enrolled in this study. Two-dimensional right ventricular systolic function index (TAPSE), systolic peak of systolic wall of tricuspid annulus (TRV) and right ventricle (RVa). RV-3DE was used to acquire the right ventricular total volume (RV) images in the right atrium and the left ventricle by RT-3DE. TomTec RV-Function software was used to analyze RVOT (RVEF). The right ventricular systolic function indexes of 2DE and RT-3DE in TOF group and normal control group were compared and analyzed. Results The right ventricular systolic function indexes of RVEF and 2DE obtained by RT-3DE in TOF group were lower than those in normal control group (P <0.05). There was a positive correlation between each index of 2DE and RVEF obtained by RT-3DE (P <0.01). The correlation between TAPSE and RVEF was the best, r = 0.574, P = 0.000. ROC curve analysis indicated that RVEF > 45% with a sensitivity of 80% and a specificity of 78% (P = 0.000). Conclusions Right ventricular systolic function is reduced in children with TOF. RT-3DE makes it possible to evaluate non-invasive right ventricular ejection fraction quickly and noninvasively.