多平面经食管超声心动图在房间隔缺损中的诊断价值

Clinical Value of Multiplane Transesophgeal Echocardiography in the Diagnosis of Atrial Septal Defect

目的 探讨多平面经食管超声心动图(MTEE)对房间隔缺损(ASD)的诊断价值。方法 对经胸超声心动 图(TTE)拟诊或疑诊为房间隔缺损以及诊断不明确患者66例行多平面经食管超声心动图检查。结果 (1)66例 行MTEE检查插管均获成功,全部患者均能耐受检查。除1例患者因脊柱畸形未能显示良好图像外,65例均清楚 显示心脏结构,图像清晰。(2)66例中,诊断不同解剖类型房间隔缺损54例,其中房间隔缺损为双孔或多孔者4 例。(3)MTEE排除TTE诊断或疑诊为ASD11例,其中,9例房间隔结构正常,1例房间隔膨出瘤、1例为卵圆孔开 放(未闭)。结论 MTEE能清晰显示ASD的位置、大小、数目及分流信号,对多孔型ASD、静脉窦型ASD和卵圆 孔开放的诊断明显优于TTE,对ASD的诊断和鉴别诊断具有重要价值,是一种安全、可靠的方法。

Objective To study the value of multiplane transesophgeal echocardiography(MTEE)in the diagnosis of atrial septal defect(ASD).Methods Sixty-six cases with preliminarily diagnosed or suspected ASD and unclear diagnosis after transthoracic color Doppler echocardiography(TTE)were studied with MTEE.Results (1) MTEE could be safely and successfully performed.All the patients tolerated well.Clear heart imaging was demonstrated in all cases except 1 case with vertebral column malformation.(2)Fifty-four cases were diagnosed as various anatomical types of ASD.Of them,two or multiple holes of ASD were demonstrated by MTEE in 4 cases.(3)Eleven cases suspected or diagnosed as ASD by TTE were corrected by MTEE and normal atrial septum structure were demonstrated in 9 cases,interatrial septal aneurysm in 1 case,fossa ovalis opening in 1 case.Conclusion MTEE could clearly demonstrated the location,the size,the number of ASD and shunt of flow and was highly superior to TTE in detecting multiple ASD,sinus venous ASD and fossa ovalis opening.It is a safe and reliable method and there are important values in diagnosis and differential diagnosis of ASD.