二维超声房间隔平面切面扫查在诊治房间隔缺损中的应用价值

Application value of two-dimensional ultrasound atrial septum plane section scanning in the diagnosis and treatment of atrial septal defect

目的探讨二维超声房间隔平面切面扫查在诊治房间隔缺损(ASD)中的应用价值。方法选择53例继发孔型ASD患者,依次采用常规切面、房间隔平面切面、实时三维超声心动图(RT-3DE)重建观察ASD形态并测量最大径线,比较三种方法测量的最大径线,并记录测量用时。分析行介入封堵术治疗患者三种方法测量值与封堵器大小的相关性,并采用房间隔平面切面观察患者术后ASD补片情况。结果常规切面、房间隔平面切面、RT-3DE测量ASD最大径线的成功率分别为100.0%、98.1%、94.3%。房间隔平面切面与RT-3DE测量的ASD最大径线值均大于常规切面(均P<0.05),而房间隔平面切面测量值与RT-3DE测量值比较差异无统计学意义(P>0.05)。RT-3DE测量ASD最大径线值的用时长于常规切面和房间隔平面切面(均P<0.05),而常规切面与房间隔平面切面测量ASD最大径线值的用时比较差异无统计学意义(P>0.05)。行介入封堵术治疗患者的封堵器型号大小与3种方法的测量值均呈正相关(均P<0.05),且房间隔平面切面的相关系数最大。房间隔平面切面可清晰显示所有行介入封堵术治疗的患者术后的补片形态。结论二维超声房间隔平面切面可较好地显示ASD形态和大小,准确性高、用时较短,为临床诊断及治疗ASD提供了新的观察角度。

Objective To explore the application value of two-dimensional ultrasound atrial septum plane section scanning in the diagnosis and treatment of atrial septal defect(ASD).Methods A total of 53 secundum ASD patients were selected.The routine section,atrial septum plane section,and real-time three-dimensional echocardiography(RT-3DE)reestablishment were performed to observe ASD morphology and measure the maximum diameter successively.The maximum diameter measured by the three different methods was compared,and the measurement duration was recorded.The correlation of the values measured by the three different methods with the size of the occluder was analyzed in patients undergoing interventional closure,and the postoperative ASD patch condition of the patients was observed by atrial septum plane section.Results The success rates of routine section,atrial septum plane section,and RT-3DE in measuring the ASD maximum diameter were 100.0%,98.1%,and 94.3%,respectively.The ASD maximum diameter measured by atrial septum plane section and RT-3DE was larger than that by routine section(all P<0.05),whereas there was no statistically significant difference in the measurement values between atrial septum plane section and RT-3DE(P>0.05).The duration of the ASD maximum diameter measurement by RT-3DE was longer than that by routine section and atrial septum plane section(all P<0.05),while there was no statistically significant difference between the duration of the ASD maximum diameter measurements by routine section and by atrial septum plane section(P>0.05).The size of the occluder in patients undergoing interventional closure positively correlated with the values measured by the three different methods(all P<0.05),and the correlation coefficient of atrial septum plane section was the largest.The postoperative patch morphology in all patients undergoing interventional closure could be clearly displayed by atrial septum plane section.Conclusion Two-dimensional ultrasound atrial septum plane section can preferably display the ASD morphology and size,exerting a high accuracy and a short duration,so as to provide a new viewing aspect in diagnosing and treating ASD in clinics.