Real-time three-dimensional transesophageal echocardiography in diagnosis of mitral papillary muscle rupture / 中国医学影像技术

ABSTRACT

Objective: To investigate the application value of real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) for diagnosing mitral papillary muscle rupture (PMR). Methods: Totally 35 patients with suspected PMR were enrolled. The mitral valve lesion and whether the lesion associated with PMR were evaluated with transthoracic echocardiography (TTE) and RT-3D-TEE preoperation. Taken surgical results as gold standards, the efficacy of preoperative RT-3D-TEE and TTE in diagnosis of mitral PMR were calculated. Results: PMR was confirmed in 25 cases by cardiac surgery, including 23 cases of posteromedial PMR and 2 cases of anterolateral PMR, while complete PMR was observed in 1 case and partial PMR in 24 cases. Mitral valve replacement was performed in 23 patients, while mitral valve repairment was performed in 2 patients. Ten cases were found without mitral PMR. Preoperation RT-3D-TEE and TTE diagnosed 23 and 20 cases of PMR, respectively. The compliance rate with surgical findings were statistical different between RT-3D-TEE (92.00% [23/25]) and TTE (80.00% [20/25]; P=0.033). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index of RT-3D-TEE in preoperative diagnosis of PMR was 92.00% (23/25), 100% (10/10), 94.29% (33/35), 100% (23/23), 83.33% (10/12) and 0.92, which of TTE was 80.00% (20/25), 90.00% (9/10), 82.86% (29/35), 95.24% (20/21), 64.29% (9/14) and 0.70, respectively. Conclusion: RT-3D-TEE can accurately depict ultrasonic features of mitral valve anatomy and pathology from different angles and viewpoints, which is an effective method for confirming mitral PMR and providing reliable information for preoperative diagnosis, intraoperative monitoring and postoperative evaluation of PMR.