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实时三维超声心动图在室间隔缺损诊断中的价值

徐兆峰,齐悦,贡欣,常亚彬,张宏艳   

  1. 天津市儿童医院
  • 收稿日期:2010-04-16 修回日期:2010-06-03 出版日期:2011-02-15 发布日期:2011-02-15
  • 通讯作者: 徐兆峰

The application of real-time three-dimensional echocardiography in the diagnosis of ventricular septal defect

  • Received:2010-04-16 Revised:2010-06-03 Published:2011-02-15 Online:2011-02-15
  • Contact: feng zhao xu

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摘要： 摘要 目的：探讨实时三维超声心动图(Real-time Three-Dimensional Echocardigraphy, RT3DE)在室间隔缺损(Ventricular Septal Defects, VSD)诊断中的应用价值。方法：102例VSD患者应用RT3DE及二维超声心动图(Two-Dimensional Echocardiography, 2DE)观察其缺损的解剖特征，并测量缺损的最大径，超声检查结果与手术观察结果比较。结果： RT3DE能从多个视角甚至模拟手术路径视野立体地显示VSD的全貌，包括缺损的解剖形态、部位、大小和毗邻关系。RT3DE测量VSD最大径为1.02±0.14 cm，2DE测量VSD最大径为0.86±0.28 cm，手术测量VSD最大径为1.05±0.36 cm。RT3DE测值与手术测值比较差异无统计学意义，2DE测值与手术及RT3DE测值比较差异有统计学意义。RT3DE测值与手术测值相关性(r=0.952)高于2DE测值与手术测值相关性(r=0.675)。结论： 相较2DE而言，RT3DE能够直接显示VSD的立体图像，其优势在于其能够直观全面地显示缺损的三维全貌，易于判断缺损的病理解剖特征，能够很方便直接地找出缺损的最大径进行测量， RT3DE能为VSD的定性与定量提供更详尽的影像信息，在治疗上能为外科手术及内科介入治疗提供更为可靠的解剖及病理信息，有利于手术适应征及手术方式的选择，具有重要的临床应用价值。

关键词: 超声心动图描记术, 实时三维, 室间隔缺损

Abstract: Abstract Objective：To evaluate the diagnostic potential of Real-time Three-Dimensional Echocardiography (RT3DE) in Ventricular Septal Defects (VSD). Methods：102 patients with VSD were diagnosed by RT3DE and Two-Dimensional Echocardiography (2DE), and the results were compared with surgical findings. Results：The defects were delineated objectively from many unique directions and angles by RT3DE that would not be available with 2DE, even simulated intraoperative visualization. The RT3DE views of VSD including the anatomical shape, positon, size and spatial relations could be appraised in their nature. The VSD maximum diameters obtained from RT3DE was 1.02±0.14 cm, from 2DE was 0.86±0.28 cm, from surgical findings was 1.05±0.36 cm. There was no statistical difference between measurements made by RT3DE and those obtained at surgery, there was a statistical difference between 2DE and RT3DE or surgical findings. Conclusion：Compared with the 2DE, RT3DE could display the true stereoscopic views of VSD, and provide better quantitative evaluation of the size, and lead to an improved understanding of the pathophysiology of VSD. RT3DE has important applied potentiality in clinical field.

Key words: Echocardiography, Real-time three-dimensional, Ventricular septal defect