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目的应用经食管实时三维超声定量分析二尖瓣成形术前后瓣环三维立体结构的变化。方法入选二尖瓣脱垂并单纯施行二尖瓣成形术的患者38例为病例组,对照组20例。应用经食管实时三维超声观察并使用Qlab软件分析瓣环结构。结果病例组术前瓣环前后径、横径、2D投影面积、3D面积较对照组增大(P均<0.05),椭圆度减小(P<0.05),高度、3D面积与2D投影面积之比及高度与横径之比无明显差异(P均>0.05)。病例组术后瓣环椭圆度较术前明显增大(P<0.05),与对照组相近,其余各指标均显著减小(P均<0.05)。结论二尖瓣脱垂患者瓣环扩张、形态趋于圆形;成形术后瓣环明显缩小、椭圆形态恢复、马鞍形态扁平化,近期效果良好,远期意义值得随访观察。
Objective To quantitatively analyze the changes of the three-dimensional structure of the annulus before and after mitral valvuloplasty using transesophageal real-time three-dimensional ultrasound. Methods Thirty-eight cases of mitral valve prolapse and simple mitral valve valvuloplasty were selected as the case group and 20 cases of the control group. Real-time three-dimensional transesophageal echocardiography was performed and the annulus structure was analyzed using Qlab software. Results The anteroposterior diameter, transverse diameter, 2D projection area and 3D area of the valve ring in the case group were significantly higher than those in the control group (all P <0.05), and the ovality was decreased (P <0.05). The height, 3D area and 2D projection area There was no significant difference in the ratio of height to diameter (P> 0.05). In the case group, the ovarian loop of the annulus increased significantly (P <0.05), compared with the control group, the rest of the indexes decreased significantly (all P <0.05). Conclusions The annulus of patients with mitral valve prolapse dilates and the shape tends to be round. The shape of the annulus is obviously reduced after the operation, the shape of the ellipse is restored, the shape of the saddle is flattened, and the short-term effect is good. The long-term significance is worthy of follow-up observation.