The Clinical Value Of Four-dimensional Echocardiography In Patients With Left-side Cardiac Valve Disease

Objective:To explore the clinical value of four dimensional echocardiography in patients with left-side cardiac valve disease.Methods:60 patients with left-side cardiac valve disease were examined with transthoracic echocardiography (TTE)> transesophageal echocardiography(TEE) and four-dimensional reconstruction(4D).All patients accepted morphology study, the valves apparatus were displayed with various perspectives. The quality of the image was evaluated by grading,and were made "Jonckheere-Terpstra" test among three groups . In 32 patients with mitral valve(MV) stenosis,4D's mitral valve area (MVA)were made linear correlation analysis with TTE's MVA through "pressure half time"(PHT). In 26 patients accepting aortic valve replacement,the largest diameters of aortic annulus measured by 4D, TTE and TEE were made linear correlation analysis and multiple linear regression with that measured in operation, and their regression equation were achieved.Results: 1.4D reconstruction image can display the stereo-anatomic structures , the valve movement and their surroundings. 2. The "mean rank" on "valvlar surrounding" , "valvuar opening"and "valvular annulurs"was significantly higher in 4D than in TTE and TEE,and it on "subvalvular structures" was significantly lower in 4D than in TTE and TEE, but the "mean rank" on "leaflets acting " and "leaflets thickness"had no significant difference among the three groups . 3.4D's MVA had close correlation with that by TEE (r=0.908 P<0.05) .4. The largest diameters of aortic annulus measured in 4D and TEE had closer correlation than in TTE with that measured in operation.Conclusions: 1 .Four-dimensional echocardiography can successfully achieve reconstructing the whole structures of left-side cardiac valve. 2.Four-dinentional image has superiority in stereo display and all-around display of valvular structures, it can provide more detaih vivid* and stereo information for operation.3.In the measurement of MVA,4D image can serve as a novel way of quantitative diagnose.4. Being free of the plane's limitation, 4D echocardiography can measure aortic valve annular's diameter accurately,and guide the selection of prothetic valve .