实时三维超声心动图诊断先天性三尖瓣畸形

Real-time three-dimensional echocardiography in diagnosis of congenital malformation of tricuspid valve

目的探讨实时三维超声心动图对先天性三尖瓣畸形的诊断价值。方法回顾性分析34例三尖瓣畸形患者的临床、常规及三维超声心动图诊断资料。结果 34例患者中,Ebstein畸形25例,三尖瓣闭锁4例,三尖瓣发育不良3例,三尖瓣瓣叶数目异常(二叶式畸形及瓣叶大部分缺如)2例;其中合并房间隔缺损15例(15/34,44.12%),动脉导管未闭、室间隔缺损各4例(4/34,11.76%),肺动脉瓣闭锁、二尖瓣前叶脱垂、单心室各3例(3/34,8.82%),卵圆孔未闭、右心室发育不良各2例(2/34,5.88%),左心室心尖部心肌致密化不全、纠正型大动脉转位、右心室双出口、共同动脉干Ⅲ型各1例(1/34,2.94%)。除2例三尖瓣闭锁患儿出生后1年内于术前死亡外,余所有患者均接受手术治疗证实超声诊断。结论实时三维超声心动图结合常规二维超声心动图对无创、准确诊断先天性三尖瓣畸形及其合并心内畸形具有重要价值。

Objective To explore the value of real-time three-dimensional echocardiography in diagnosis of congenital tricuspid anomalies.Methods A total of 34 patients with congenital tricuspid anomalies were enrolled retrospectively,and their datum of clinical and echocardiographic diagnosis were studied.Results In 34 patients,25 cases of Ebstein anomaly,4 cases of tricuspid atresia,3 cases of tricuspid valve dysplasia,2 cases of tricuspid valve numbers abnormity.The most common associated intracardiac malformation was arterial septal defect in 15 cases（15/34,44.12%）,4 cases（4/34,11.76%）had patent ductus arteriosus and 4 cases（4/34,11.76%）had ventricular septal defect,3 cases（3/34,8.82%）of pulmonary valve atresia,3cases（3/34,8.82%）of single ventricle and 3 cases（3/34,8.82%）of mitral anterior leaflet prolapse,2 cases（2/34,5.88%）of patent oval foramen and 2 cases（2/34,5.88%）of right ventricle dysplasia,and the left ventricle noncompaction,corrected transposition of the great artery,double-outlet right ventricle,truncus arteriosus were found 1 case（1/34,2.94%）,respectively.Among them,all of them confirmed by surgery besides 2 cases of tricuspid atresia died without operation within 1year.Conclusion A combination of real-time three-dimensional echocardiography and echocardiography are the non-invasive and accurate methods for congenital tricuspid anomalies and the intracardiac malformations.