实时三维超声心动图诊断小儿先天性心脏病的应用研究

Application of real-time three-dimensional echocardiography to the diagnosis of congenital heart malformations in children

目的评价实时三维超声心动图(RT-3DE)诊断小儿先天性心脏病(先心病)的可靠性。方法2004年3月至2004年7月复旦大学附属儿科医院心血管中心诊治的各种先心病患儿62例,其中男23例,女39例,年龄16d至12岁4个月。应用Philips/SONOS7500超声诊断仪,采用VanPraagh“节段分析法”和局部解剖学的剖视方法进行RT-3DE检查,以心血管造影和(或)手术诊断为金标准,与二维彩色多普勒超声心动图(CDE)检查结果进行比较。结果62例均获得较满意的三维容积图像,在心内解剖结构及近心端大血管走行方面能提供更丰富准确的空间解剖信息。RT-3DE在主要畸形的诊断方面与CDE一致率达98.4%。RT-3DE修正或补充CDE的诊断6例(9.7%)。结论RT-3DE能对各种小儿先心病做出更准确的诊断。

Objective To evaluate the reliability of real-time three-dimensional echocardiography （ RT-3DE ） in the diagnosis of congenital heart diseases （ CHD）. Methods Sixty two pediatric patients （23 male,39 female） with congenital heart diseases, aged 3.25 ± 2. 88 years, were examined by RT-3DE of Philips SONOS 7500 ultrasonic system. Van Praagh segmental analysis procedure and the principle of topographic anatomy were used to analyze the volumetric images. Based on the findings of angiocardiography and/or surgery ,the results were compared with those diagnosed by Color Doppler ech- ocardiography （ CDE）. Results Technically satisfactory volumetric images of RT-3DE were obtained in all subjects. These volumetric images could provide more accurate spacial information in aspects of intracardiac anatomy and the course of great arteries. Out of 62 patients, the major defects in 61 （98.4% ） diagnosed by RT-3DE were consistent with those by CDE. However,some minor defects were corrected,revealed,or modified by RT-3DE in 6 patients （9.7% ）. Conclusion RT-3DE can make more accurate diagnosis in CHD.