动态三维超声在风湿性二尖瓣狭窄诊断中的应用价值

Value of dynamic three-dimensional echocardiography in diagnosis of rheumatic mitral stenosis

目的探讨动态三维心动图在风湿性二尖瓣狭窄病变的临床应用价值。方法对36例风湿性二尖瓣狭窄患者进行二维超声和三维超声重建,从不同的方向观察二尖瓣瓣膜的形态、活动以及对瓣口面积进行测量分析,并与手术中实测结果对照。结果动态三维超声心动图可显示二尖瓣狭窄的形态,同时更容易切取瓣口最小面积平面。二维超声所测的二尖瓣口面积为(1.40±0.13)cm2,动态三维超声心动图所测的二尖瓣口面积为(1.37±0.14)cm2,手术所测的二尖瓣口面积为(1.35±0.15)cm2。风湿性二尖瓣狭窄病例,用二维平面法、动态三维容积法与手术测得的二尖瓣口面积均呈良好的相关(r分别=0.66、0.86,P均<0.05),经手术测得的二尖瓣口面积略小于三维容积法(t=0.58,P>0.05),三维容积法又略小于二维平面法(t=0.97,P>0.05)。结论动态三维超声心动图可准确反映膜狭窄的真实程度,为临床诊断和治疗提供更可靠的依据。

Objective To explore the clinical value of dynamic three - dimensional eehocardiography on rheumatic mitral stenosis pathological change, Methods Two - dimensional echocardiography and three - dimensional echocardiography for 36 patients of rheumatic mitral stenosis were reconstructed. From different direction, the shape and the action were observed and measuring analysis for the area of petal was done to compared with the results of the operation. Results MVA in patients with MS measured by operation correlated well with MVA by 2D （r = 0.66, P 〈 0.05 ） and by 3D （r = 0.86, P 〈 0.05） . MVA by operation was slightly lower than that by 3D. MVA by 3D was slightly lower than that by 2D. Conclusions Dynamic three - dimensional echocardiography can show the shape of mitral stenosis, and it is easy to acquire the optimal plane of the smallest MVA circle , which has great value in clinical diagnosis and treatment.