实时三维彩色血流成像技术定量评价室间隔缺损分流量的初步探讨

Quantification of shunt volume of ventricular septal defect by real-time three-dimensional color Doppler flow imaging: initial exploration

目的探讨实时三维彩色血流成像技术(RT-3DCDFI)评价室间隔缺损分流量的价值。方法应用RT-3DCDFI成像技术采集46例单纯性室间隔缺损(VSD)患者的三维彩色分流信号数据,导入TomTec三维图像工作站,于收缩期采用八平面法勾画并计算分流束的彩色血流信号容积(SJV),并与二维频谱多普勒法QP-QS所测得分流量结果行相关性分析。结果①缺损直径小于或等于主动脉根部直径2/3的小、中VSD的SJV值与QP-QS值相关良好(r=0.87;r=0.79),且两者的均值无显著性差异(P>0.05);②缺损径线大于主动脉根部直径2/3的大VSD,RT-3DCDFI所测SJV值明显低估分流量(r=0.55)。结论RT-3DCDFI技术可从三维空间对VSD分流进行评估,为临床定量评估中小型VSD的分流提供了一种新方法。

Objective To evaluate the use of real-time three-dimensional color Doppler flow imaging (RT-3D CDFI) in the noninvasive assessment of color Doppler shunt jet volume (SJV) in patients with isolated ventricular septal defect (VSD). Methods Fourty-six patients with VSD were examined by RT-3D CDFI. The shunt volume was manually outlined by the eight-plane method with TomTec 4D Cardio workstation. Comparative analysis was performed between the results of RT-3D CDFI and traditional two-dimensional methods. Results SJV of small and medium ventricular septal defects had good correlation with Q_P-Q_S respectively, which was obtained by frequency Doppler method (r=0.87 and r=0.79). However, SJV of large ventricular septal defects was underestimated by RT-3D CDFI (16.61 ml vs 68.13 ml, r=0.55, P<0.05). Conclusion This study indicates that RT-3D CDFI can provide a new reliable and accurate way to assess shunt blood flow of small and medium VSD.