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目的采用经食管实时三维超声心动图(RT 3D-TEE)重建二尖瓣解剖结构,探讨二尖瓣环、瓣叶各参数随心动周期的变化规律。方法 18例阵发性房颤患者行RT 3D-TEE检查,于左室长轴观采集3个心动周期包含完整二尖瓣环及瓣叶的三维超声图像。运用eSie Valves分析软件获得二尖瓣环及瓣叶各参数的动态值。结果二尖瓣环面积、周长、前后径、连合间径、非平面角度、主动脉瓣环与二尖瓣环间夹角测值收缩期<舒张期(P<0.05),而瓣环高度、瓣环高度/连合间径测值收缩期>舒张期(P<0.05);前瓣叶总面积及A1、A2、A3区面积和长度收缩期<舒张期(P<0.05),后瓣叶总面积及P1、P2、P3区面积和长度在收缩期和舒张期间的差异无统计学意义(P>0.05)。二尖瓣各参数组内及组间测值的一致性分析显示一致性好。结论 RT 3D-TEE能快速定量分析二尖瓣环及瓣叶各参数随心动周期的变化规律,且一致性好,可为二尖瓣的修复、置换手术提供参考。
Objective To reconstruct mitral valve anatomy using real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) and investigate the changes of mitral valve and leaflet parameters with cardiac cycle. Methods Twenty-eight patients with paroxysmal atrial fibrillation were examined by RT 3D-TEE. Three long-axis views of the left ventricle were collected for three-dimensional echocardiography including complete mitral annulus and valve leaflets. Use eSie Valves analysis software to obtain dynamic values of mitral annulus and leaflet parameters. Results The mitral valve annulus area, perimeter, anteroposterior diameter, interventricular septum diameter, nonplanar angle, the systolic phase between diastolic and aortic annulus and systolic annulus (diastolic phase (P <0.05) (P <0.05). The total area of the anterior leaflet and the area of A1, A2 and A3 and the systolic length of diastole (<0.05) The total area of leaflets and the area and length of P1, P2 and P3 in systole and diastole were not statistically different (P> 0.05). Consistency analysis of mitral valve parameters within and between groups showed good agreement. Conclusion RT-3D-TEE can rapidly and quantitatively analyze the variation of mitral and mitral valve parameters with cardiac cycle, and has good consistency. It can provide a reference for the repair and replacement of mitral valve.