Clinical application of real-time three-dimensional transesophageal echocardiography in diagnosis of mitral valve prolapse / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the clinical application value of real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) in diagnosis of mitral valve prolapse(MVP).Methods Twenty patients with MVP with more than moderate mitral regurgitation referred for mitral valve repair (MVR) were studied.All patients underwent RT-3D-TEE and mitral valve quantification(MVQ) before MVR.The location of scallop lesions and ruptured mitral chordae tendineae for mitral valve were evaluated,and compared with surgical findings.Carpentier's nomenclature was applied to the mitral valve anatomic localization either RT-3D-TEE or surgery.There were three anterior leaflet scallops defined as A1,A2 and A3,and three posterior leaflet scallops defined as P1,P2 and P3.Results ① The shape and spatial structure of the scallop lesions and ruptured mitral chordae tendineae of mitral valve were clearly displayed by RT-3D-TEE,also could be observed through left atrium view and left ventricular view.② Compaired with surgical findings,RT-3D-TEE was of high sensitivity (100 ％),higher specificity (95.46 ％) and crude agreement (95.83％) in the location of P2,the positive likelihood ratio of location of P2 (22.03) was the biggest,the negative likelihood ratio (0) was the smallest.③ RT-3D-TEE had lower sensitivity (66.67％),specificity (83.76 ％) and crude agreement (83.33 ％) in the diagnosis of location of P1 than other locations,the positive likelihood ratio(4.11) was the smallest,the negative likelihood ratio (0.40) was the biggest.④ The sensitivity,specificity,crude agreement,positive likelihood ratio and negative likelihood ratio of RT-3D-TEE in diagnosis of ruptured mitral chordae tendineae accompanied by MVP were 100％,91.67％,95.00％,12.00,0 respectively.Conclusions RT-3D-TEE could clearly display the three-dimensional structure of the lesions of mitral valve.It was of better accuracy in diagnosis of the location of scallop lesions of mitral valve and the rupture of chordae tendineae,and was of important clinical application value in MVR.