经食管实时三维超声心动图诊断房间隔缺损的应用价值

Primary study of the utility of transesophageal real-time three-dimensional echocardiography in the diagnosis of atrial septal defect

目的探讨经食管实时三维超声心动图（RT-3D-TEE）诊断房间隔缺损的应用价值。方法应用PhilipsiE33型彩色多普勒超声诊断仪，X7—2t经食管纯净波矩阵多平面实时三维探头，对经食管二维超声心动图（2D-TEE）检查的23例患者进行RT-3D-TEE检查。其中经胸二维（2D-TTE）诊断房间隔缺损20例，可疑房间隔缺损3例。结果23例患者均获得满意的三维图像，RT-3D-TEE可以从不同角度清楚显示房间隔缺损的位置、大小、有无残端及与毗邻结构的关系。23例患者RT-3D-TEE检查后全部明确诊断，其中房间隔缺损22例，卵圆孔未闭1例。在对房间隔缺损最大径的测量中，2DTTE、2D-TEE及RT-3D-TEE三种测量方法之间相比差异无统计学意义（P〉0．05）。RT-3D-TEE显示房间隔缺损直径测量值与手术实际测值呈高度相关。结论RT-3D-TEE具有实时、快速成像的特点，可以同步清晰显示房间隔缺损的位置、立体大小和毗邻结构的关系。

Objective To investigate the value of real-time three-dimensional transesophageal echocardiography（RT-3D-TEE） in the diagnosis of atrial septal defect. Methods Philips iE33 was used to detect twenty-three patients[17 female,6 male, mean age （34.4 ± 10.6） years], in which 20 patients were diagnosed in atrial septaldefect by transthoracic echocardiography（TTE）, 3 patients with doubt of atrial septal defect. Results 3D images were clearly gained by RT-3D-TEE. It could detect the location,size,and extent of atrial septal defect. Twenty-three patients were definitely diagnosed,including atrial septal defect 22 cases,patent foramen ovale 1 case. There were no significant differences among the measurements for the size of atrial septal defect by 2D-TTE,2D-TEE and RT-3D-TEE （ P 〉0. 05）. The diameter of atrial septal defect measured by RT-3D-TEE were highly correlated with surgical measurement. Conclusions RT-3D- TEE has the characteristic of on-line guidance and fastly obtaining 3D imaging. It can clearly show the location,size and the extent structures of atrial septal defect on line.