经胸实时三维超声心动图在室间隔缺损诊断中的应用价值

Clinical Application of Real-time Three-dimensional Echocardiography in the Diagnosis of Ventricular Septal Defect

目的 :探讨实时三维超声心动图在室间隔缺损诊断中的临床应用价值。方法 :应用实时三维超声诊断仪获取 2 8例先天性室间隔缺损患者的三维数据库 ,并利用三维数据工作站对缺损大小进行测量分析 ,其中 18例患者的三维测量值与二维超声及手术结果对照。结果 :实时三维成像能从多个视角、甚至模拟手术路径立体显示室间隔缺损的全貌 ,包括缺损的整体形态、部位、大小以及毗邻关系 ;同二维超声所测直径相比 ,三维超声所测室缺最大长轴径与手术结果具有更好的相关性 (r =0 .92vsr=0 .84 )。结论 :与二维超声心动图比较 ,实时三维超声心动图反映了室间隔缺损的立体空间结构 ,可对缺损大小进行准确的定量分析 ;与以往三维重建超声相比 ,实时三维超声可迅速得到室间隔缺损的三维图像 ,具有重要的临床应用潜力。

Objective: To evaluate the diagnostic potential of real-time three-dimensional echocardiography (RT 3DE) in ventricular septal defects (VSD). Methods: Twenty-eight adult patients with VSD were studied by RT 3DE and two-dimensional transthoracic echocardiography (2D TTE). 3D image database was post-processed using 3D work-station. Of the 18 patients, RT 3DE studies had been comfirmed at operation, and the results were compared with those measured by 2D TTE and surgery. Results: The defects were delineated objectively from many unique directions and angles by RT 3DE that would not be available with other current techniques, even simulated intraoperative visualization. The stereoscopic views of VSD including the shape, position, size and spatial relations could be appraised in their nature.The VSD maximum diameters obtained from RT 3DE had better correlation with surgical findings than those measured by 2D TTE (r=0.92 vs r=0.84). Conclusion:Compared with the 2D TTE, RT 3DE could reflect the true stereoscopic views of VSD, and provide better quantitative evaluation of the size. It is also better than former three-dimensional voxel imaging of echocardiography in acquiring quick images of the VSD real-time. RT 3DE has important applied potentiality in clinical field.