经食道实时三维超声心动图对结构性心脏病的诊断价值

Diagnostic value of real-time three-dimensional transesophageal echocardiography in structural heart disease

目的评价经食道实时三维超声心动图(RT-3DTEE)在结构性心脏病的诊断价值。方法临床疑诊为心脏病患者60例,行RT-3DTEE检查。结果 RT-3DTEE诊断左心耳血栓1例;继发孔中央型房间隔缺损4例,其中2处房间隔缺损1例,上腔静脉窦型房缺1例,原发孔房间陋缺损合并二尖瓣、三尖瓣瓣叶裂1例;卵圆孔未闭2例;室间隔缺损伴周围纤维组织形成1例;二尖瓣及主动脉瓣赘生物各1例;二尖瓣机械瓣瓣周漏1例;二尖瓣机械瓣功能障碍1例;二尖瓣机械瓣纤维翳形成1例;二尖瓣腱索断裂2例;左房黏液瘤2例;房间隔瘤1例;左房内钙化灶1例。结论 RT-3DTEE可实时立体观察心脏的结构及血流动力学改变,为结构性心脏病的准确诊断和治疗提供客观的信息。

Objective To evaluate the diagnostic value of real-time three-dimensional transesophageal echocardiography （RT-3DTEE） in structural heart disease. Methods Sixty patients with clinically suspected heart diseases were enrolled for RT-3DTEE examination. Results RT3D-TEE detected 1 case with left atrial appendage thrombus, 4 cases with secundum atrial septal defect （ASD）, 1 case with ASD of 2 holes, 1 case with superior sinus venous ASD, 1 case with primum ASD of mitral and tricuspid clefts, 2 cases with patent foramen ovale, 1 case with ventricular septal defect （VSD） of associated surrounding fibrous tissue. Detected 1 case with mitral valvular vegetation and 1 case with aortic valvular vegetation respectively, 1 case with mitral periprosthetic leakage, 1 case with mitral mechanical valve dysfunction, and 1 case with mitral mechanical valve of fibrous nebula generation, 2 cases with mitral valve chordae rupture. In addtiton, 2 cases with left atrial myxoma, 1 case with atrial septal aneurysm and 1 case with calcification in the left atrium were detected. Conclusion RT3D-TEE can provide real-time three-dimensional view of the cardiac structure and hemodynamie changes, and supply precise information for accurate diagnosis and treatment of structural heart disease.