常见先天性心脏缺损平面几何形态学的二维与三维超声对比研究

Comparative Study of Two-dimensional and Three-dimensional Echocardiography in Evaluating Plane Geometrical Morphology of Common Congenital Heart Defects

目的应用二维超声心动图(2DE)显示常见先天性心脏间隔缺损的平面图像并进行平面几何学测量,评价2DE显示缺损平面图像的可行性及潜在临床价值。资料与方法应用2DE和RT3DE对包括房间隔缺损、室间隔缺损、完全型心内膜垫缺损、主-肺动脉间隔缺损和窗型动脉导管未闭在内的经手术证实的81例先天性心脏病患者进行观察,使用特殊的2DE切面显示心脏缺损的平面图像,使用电子游标测量缺损长轴径、短轴径、面积及偏心比值,并与RT3DE结果进行对比。结果 81例患者中,67例应用2DE成功获得与RT3DE显像形态学相似的理想的缺损平面图像,房屋间隔缺损在2DE缺损平面图像上的长轴径、短轴径、面积及偏心比值与RT3DE测值高度相关(r=0.99、0.99、0.99、0.95,P<0.001),差异均无统计学意义(P>0.05)。结论 2DE对先天性心脏缺损可获得与RT3DE效果相似的平面图像,能精确地评价缺损形状、位置及毗邻关系,并可借以实现缺损平面几何参数的直接测量。

Purpose To investigate the feasibility and possible clinical value of twodimensional transthoracic echocardiography （2DE） in displaying plane geometrical morphology of patients with congenital heart defects （CHDs） by comparing with real-time three-dimensional echocardiography （RT3DE）. Materials and Methods 2DE and RT3DE were applied to monitor 81 consecutive patients with CHDs including atrial septal defect, ventricular septal defect, endocardial cushion defect, aortic-pulmonary septal defect, and patent ductus arteriosus. Moreover, special en face view of 2DE was used to display the defect in all patients and long axis length, short axis length, area and eccentricity ratio （major/minor axis length） of the defect were measured. The results were compared with that measured by RT3DE. Results Satisfied en face plane views was obtained by 2DE in 67 of 81 patients when compared with RT3DE. The maximum diameters, minimum diameters and areas obtained on from 2DE have significant correlation with that measured by RT3DE （r=0.99, 0.98, 0.99, 0.99, P0.001）. Conclusion 2DE can provide en face views of CHDs which are similar to that of RT3DE. 2DE can assess the shape and location of the defect as well as the adjacent structures, thus, it enables direct measurement of plane geometrical parameter of the defect.