| More and more researches indicated that it is of great significance in evaluation of right ventricular volume and function in clinical utility, which could predict prognoses of many heart diseases. Conventional M-mode and two dimensional echocardiography(2DE) are the most common noninvasive tool used for ventricular volume evaluation. But the irregularly lunular right ventricle(RV) anatomic configuration, slick RV endocardial surface , and difference of RV inflow tract and outflow tract plane, make RV much more complicated than left ventricle(LV) in morphology. So when it comes to measuring right ventricle volume and function, it may be inaccurate if we use traditional echocardiographic volumetric measurement methods, which are relied on geometric model assumption of regular LV shape and well used in LV volumetric evaluation. Real-time Three-dimensional Echocardiography (RT-3DE) is a newly developed medical ultrasound technology with important clinical application value. It can display stereoscopic structure of heart in real time and quickly acquire the three-dimensional data bank. Using RT-3DE, we can observe the morphology of cardiac and the nearby structures. In addition, it can measure ventricular volume and function without geometric model assumption. Even when ventricle is pathologically remodeled and with obvious aberrant formation, RT-3DE can also give us accurate outcomes, so its clinical utility developes well now.The aim of our research is to explore the feasibility and accuracy of measuring right ventricular volume and function by RT-3DE, and our research includes 2 parts. In the primary part, we validated the accuracy of measuring right ventricular volume and mass of excised porcine hearts using RT-3DE. We simultaneously examined the hearts with RT-3DE full volume imaging, multi-detector row computed tomography (MDCT) and magnetic resonance imaging(MRI). Results from above-mentioned methods were compared with values from RV cast moulds. In the second part, firstly, we measured volumes of ten RV model by real-time tri-plane imaging, and 2DE bi-plane Simpson method, then compared volumetric values from echocardiography and those measured by water replaced. Lately, we measured right ventricular volume and function by real-time tri-plane imaging in 36 healthy individuals, and compared the values with left ventricular volume and function measured by bi-plane Simpson method. The two parts are as follow:Part 1. Study of real-time three-dimensional echocardiography on quantifying right ventricular volume and mass: comparison with MDCT and MRIIn this part, we aimed to evaluate the feasibility and accuracy of real-time three-dimensional echocardiography (RT-3DE) in quantifying right ventricular volume (RVV) and right ventricular mass(RVM). RVV and RVM of 10 excised porcine hearts were measured by RT-3DE full volume imaging . The corresponding data were also obtained by multi-detector row computed tomography (MDCT) and magnetic resonance imaging(MRI). The results from above imageologic methods were compared with true values from RV cast moulds. Resultsâ‘ RV shapes viewed from imageologic methods were similar to RV cast mould of porcine.â‘¡There were no statistically significant differences between RVV measured by these 3 imageologic methods and those measured by cast mould (P>0.05). And values from RT-3DE,MDCT and MRI showed high correlations with values from cast mould (r =0.882; 0.924; 0.928 respectively).â‘¢There were no statistically significant differences between RVM measured by these 3 imageologic methods and those measured by segregating RV integrity and weighing(P > 0.05). And values from RT-3DE,MDCT and MRI showed high correlations with values from weighing(r =0.822; 0.897; 0.901 respectively).Part 2. Experimental and clinical study of measuring right ventricular volume and function by real-time tri-plane imaging In this part, we aimed to evaluate the feasibility and accuracy of real-time tri-plane imaging in measurement of right ventricular(RV)volume and function. Firstly, volumes of ten RV model were measured by real-time tri-plane imaging and 2DE bi-plane Simpson method, compare with the true volumes of model measured by water replaced. Lately, we examined 36 healthy volunteers with echocardiography. Right ventricular end-diastolic volume (RVEDV),right ventricular end-systolic volume (RVESV) and right ventricular stroke volume (RVSV) were measured by real-time tri-plane imaging. Using conventional echocardiography, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular stroke volume (LVSV) were measured by bi-plane Simpson methods. Values from these two methods were compared. Resultsâ‘ All the rubber RV model can be displayed clearly and satisfactorily by real-time tri-plane imaging and 2DE. The shapes of models were similar to their actual stereoscopic shape.â‘¡There was no statistically significant difference between volumes from real-time tri-plane imaging, Simpson method and the model volume (P>0.05). Volumes from real-time tri-plane imaging and Simpson method showed high correlations with that from RV model (r =0.978; 0.948, respectively).â‘¢There were no statistically significant differences between RVEDV,RVEDV and RVSV measured by real-time tri-plane imaging and LVEDV,LVESV,LVSV measured by 2DE (P>0.05), and there were high correlations too(r =0.734; 0.721; 0.783, respectively).CONCLUSIONS:â‘ RT-3DE full volume imaging could quantify right ventricular volume and mass quickly and exactly. Comparing with MDCT and MRI, it is more convenience and shows great potential to evaluate right ventricular volume and mass in clinical applications.â‘¡Real-time tri-plane imaging can on line measure right ventricular volume and function, and provides us a fast, non-invasive technique to evaluate right heart. Ventricle Volume Mass Function Stroke volume...
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