腹部三维超声模拟内镜模式评价先天性心脏间隔缺损的价值

Value of Imitated Endoscopic Type of Abdominal Three-Dimensional Surface Ultrasonography in Evaluation of Congenital Cardiac Septal Defects

目的探讨应用腹部三维超声表面成像摸拟内镜模式对评价先天性心脏间隔缺损的价值。方法对30例心脏间隔缺损病例进行二维彩色多谱勒检查,心脏缺损部位应用腹部三维超声内镜模式进行三维表面成像,比较二维图像与三维图像的差别。结果 30例患者中,25例房间隔缺损(房缺)、3例室间隔缺损(室缺)三维重建成功,腹部三维超声对房缺、室缺可获满意图像;另2例三维重建失败。三维成像较二维图像更易观察缺损全貌及缺损的游离缘。房缺与室缺的二维超声测值分别与其三维超声测值呈直线正相关(r分别为0.806、0.703,P<0.05),房缺与室缺的三维超声测值亦与术中所用的封堵器直径呈直线正相关(r分别为0.798、0.755,P<0.05)。结论三维超声与二维超声测值及封堵器直径有良好的相关性,腹部三维超声内镜模式表面成像可对先天性心脏间隔缺损程度进行较好的评价。

Objective To investigate the value of imitated endoscopic type of abdominal three-dimensional surface ultrasonography in the evaluation of congenital cardiac septal defects.Methods Two-dimensional echocardiography was carried out in 30 patients with congenital cardiac septal defects and endoscopic type of abdomimal three-dimensional surface ultrasonography was performed in the cardiac defect position.The difference between two-dimensional images and three-dimensional images was observed.Results Among the 30 patients,three-dimensional reconstruction was successful in 25 patients with atrial septal defects and 3 patients with ventricular septal defects,but failed in 2 patients.Three-dimensional images were satisfactory and were easier to observe whole defects and free edge than two-dimensional images.The values of atrial septal defects and ventricular septal defects measured by two-dimensional echocardiography were positively correlated with those measured by three-dimensional surface ultrasonography（r=0.806 and r=0.703,respectively;P〈0.05）.In addition,the values of atrial septal defects and ventricular septal defects measured by three-dimensional echocardiography were positively correlated with the diameter of Amplatzer occluder（r=0.798 and r=0.755,respectively;P〈0.05）.Conclusion The values measured by two-dimensional echocardiography or three-dimensional surface ultrasonography were correlated with the diameter of Amplatzer occluder.The endoscopic type of abdomimal three-dimensional surface ultrasonography is effective for evaluating congenital cardiac septal defects.