李萌,金炫佚,马春燕,王永槐,李光源,孟平平,孔凡鑫,杨军.三维全自动左心容积定量技术评价左心室容积及射血分数的可行性及影响因素[J].中国医学影像技术,2019,35(1):63~68
三维全自动左心容积定量技术评价左心室容积及射血分数的可行性及影响因素
Feasibility and impact factors of quantitative evaluation on left ventricular chamber volumes and ejection fraction with 3D automated left ventricular quantification technique
投稿时间:2018-05-21  修订日期:2018-10-28
DOI:10.13929/j.1003-3289.201805119
中文关键词:  超声心动描记术  自动定量  左心室容积  射血分数  可行性
英文关键词:echocardiography  automated quantification  left ventricular volumes  ejection fraction  feasibility
基金项目:
作者单位E-mail
李萌 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
金炫佚 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
马春燕 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001 mcy_echo@163.com 
王永槐 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
李光源 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
孟平平 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
孔凡鑫 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
杨军 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
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中文摘要:
      目的 探讨三维全自动左心容积定量技术(HM)测量左心室容积和射血分数的可行性及其影响因素。方法 对80例患者行三维HM图像采集,采用HM技术和传统实时三维超声心动图(RT3DE)技术测量左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)和射血分数(LVEF),手动调整(HME)部分HM自动确定的心内膜边界不符合实际边界者,并进行比较,探讨其影响因素。结果 HM、HME、RT3DE测量LVEDV、LVESV和LVEF值总体差异均有统计学意义(P均<0.05),HM测值均大于RT3DE,HME测量LVEDV和LVESV均大于RT3DE(P均<0.05),而LVEF差异无统计学意义(P>0.05)。HME与RT3DE测量差值(ΔHM-RT3DE)小于HM与RT3DE测量差值(ΔHME-RT3DE,P均<0.05)。根据图像质量将患者分为A组(图像质量较好,n=54)和B组(图像质量较差,n=26),除LVESV外,A组ΔHM-RT3DE和ΔHME-RT3DE均小于B组(P均<0.05)。HM与RT3DE有良好的一致性,手动调整后一致性提高。HM和HME在观察者内及观察者间的可重复性好,组内相关系数均>0.9。结论 HM自动评价左心室容积及射血分数与RT3DE一致性好,手动调整心内膜边界可提高测量准确率,图像质量对HM测值准确率有一定影响。
英文摘要:
      Objective To observe the feasibility and impact factors of 3D automated left ventricular quantification technique-Heart Model (HM) in assessment of left ventricular volumes and ejection fraction. Methods 3D images in HM mode of 80 patients were collected, and the images were analyzed using HM and traditional real-time 3D echocardiography (RT3DE) to obtain left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF). Manual HM border editing (HME) was performed when automatic tracing border did not fit the native endocardial border. The results were compared to explore the impact factors. Results The overall differences between HM, HME and RT3DE in measuring LVEDV, LVESV and LVEF were statistically significant (all P<0.05). All the values measured with HM were greater than those with RT3DE. LVEDV and LVESV measured with HME were greater than those with RT3DE (all P<0.05), while the difference of LVEF was not statistically significant (P>0.05). The measuring differences between HME and RT3DE (ΔHM-RT3DE) were less than that between HM and RT3DE (ΔHME-RT3DE, all P<0.05). The patients were divided into group A (good image quality, n=54) and group B (poor image quality, n=26), and except LVESV, the others of the ΔHM-RT3DE of group A were less than group B (all P<0.05). HM and RT3DE had good consistency, which could be improved with manual editing. The inter-and intra-observers repeatability was good for both HM and HME, with the intraclass correlation coefficients greater than 0.9. Conclusion There is good consistency between HM and RT3DE in automatic quantification of left ventricular volumes and ejection fraction. Manual editing of endocardial border can improve the accuracy, and the image quality has certain impact on the measurements.
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