实时三维超声心动图诊断二尖瓣关闭不全

Real-time three-dimensional echocardiography in diagnosis of mitral insuffciency

目的探讨经胸实时三维超声心动图(RT-3DE)诊断二尖瓣关闭不全的价值。方法随机选取95例经手术确诊的二尖瓣关闭不全患者,对所有患者术前均行二维超声及RT-3DE检查,并与手术结果进行对比,评价二者诊断准确率的差异。结果对95例患者均成功采集RT-3DE图像。95例中,风湿性心脏病二尖瓣狭窄合并二尖瓣关闭不全48例,二维超声与RT-3DE对其诊断准确率均为100%(48/48);二维超声与RT-3DE诊断二尖瓣脱垂、二尖瓣腱索断裂、二尖瓣瓣裂、二尖瓣穿孔的准确率的差异均有统计学意义(P均<0.05)。结论 RT-3DE操作简便,成像速度快,三维图像细致,诊断准确率高于二维超声,是二尖瓣外科手术治疗前重要的检测手段。

Objective To explore the application value of real-time three-dimensional echocardiography （RT-3DE） tech- nology in the diagnosis of mitral insuffciency. Methods Ninety-five hospitalized patients with mitral insuffciency under- went the conventional two-dimensional echocardiography and RT-3DE images. Then the comparison with surgical results was made to evaluate the accuracy. Results The three-dimensional images of 95 patients were successfully captured by RT- 3DE. Among them, 48 patients suffered rheumatic heart disease mitral valve lesion. The diagnostic accuracy of the conven- tional two-dimensional eehocardiography and RT-3DE were 100 ~ （48/48）. The differences of accuracy in diagnosis of non rheumatic mitral insufficiency, mitral chordae tendineae fracture crack, mitral valve prolapse and mitral valve perforation were statistically significant （all P%O. 05）. Conclusion The RT-3DE is easily operated that features as fast imaging, clear three-dimension and high diagnostic accuracy, which provides an important preoperative examination for mitral valve surgery.