实时三维经食道超声心动图在评价成人卵圆孔未闭形态中的应用价值

Application value of real-timethree-dimensional transesophageal echocardiography in evaluating the morphology of patent foramen ovale in adults

目的探讨实时三维经食道超声心动图(RT3D-TEE)在评价成人卵圆孔未闭(PFO)形态中的应用价值。方法我院自2013年12月~2016年10月进行卵圆孔未闭封堵治疗的患者32例,术前分别应用二维经食道超声心动图(2D-TEE)及RT3D-TEE测量卵圆孔的通道长度、入口宽度、中间宽度以及出口宽度,并将测量结果进行比较。根据RT3D-TEE测量PFO入口宽度和对合长度选择不同型号的封堵器。结果 24例患者选择18/25 mm封堵器,8例选择30/30 mm封堵器。RT3D-TEE测量卵圆孔的通道长度与2D-TEE测量结果差异无统计学意义(P>0.05),RT3D-TEE测量卵圆孔入口宽度、中间宽度及出口宽度均大于2D-TEE测量结果 ,差异有统计学意义(P<0.05)。封堵后即刻复查TEE显示均无残余分流。结论 RT3D-TEE可以清晰地显示卵圆孔三维结构,提供更准确的卵圆孔形态信息。

Objective To evaluate the application value of real-time three-dimensional echocardiography（RT3D-TEE）in the evaluation of the morphology of patent foramen ovale（PFO） in adults.Methods 32 patients with PFO in our hospital from December 2013 to October 2016 who underwent two-dimensional transesophageal echocardiography（2DTEE） and RT3D-TEE before surgery to measure the channel length,inlet width,middle width and exit width of foramen ovale,and measurement result was compared.Different types of occlude were choosed according to the PFO width at entrance and involutory length measured by 3D-TEE measurement.Results 18/25 mm occlude was selected in 24 cases,and 8 cases with 30/30 mm occlude.There was no statistical difference of channel length of oval foramen measured by2D-TEE and RT3D-TEE（P〉0.05）.Inlet width,middle width and exit width of foramen ovale measured by RT3D-TEE was larger than those of 2D-TEE（P〈0.05）.TEE examination was conducted after plugging to show that there was no residual shunt.Conclusion RT3D-TEE can clearly display the three-dimensional structure of the foramen ovale and provide more accurate information about the shape of the foramen ovale.