天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (6): 653-655.doi: 10.11958/j.issn.0253-9896.2015.06.020

• 应用研究 • 上一篇    下一篇

实时三维彩色多普勒经胸超声心动图对结构性心脏病#br# 术前评估的应用

朱延波 1， 张秀红 2， 关欣 1， 耿婕 3， 骆永娟 1， 张利霞 1， 耿庆国 1   

  1. 1天津市胸科医院超声科(邮编 300222)； 2天津市儿童医院护理部； 3天津市胸科医院 CICU
  • 收稿日期:2014-08-28 修回日期:2015-01-14 出版日期:2015-06-15 发布日期:2015-06-10
  • 通讯作者: 朱延波 E-mail:zhuyanbo2008@163.com
  • 基金资助:
    天津市医药卫生重点攻关项目 （14KG125）

Application of real-time three-dimensional color doppler transthoracic echocardiography on#br# preoperative assessment of patients with structural heart disease

ZHU Yanbo1, ZHANG Xiuhong2, GUAN Xin1, GENG Jie3, LUO Yongjuan1, ZHANG Lixia1, GENG Qingguo1   

  1. 1 Department of Ultrasound, Tianjin Chest Hospital, Tianjin 300222, China; 2 Department of Nursing Management,
    Tianjin Children’ s Hospital, Tianjin 300074, China; 3 Department of Cardiac Intensive Care Unit,
    Tianjin Chest Hospital
  • Received:2014-08-28 Revised:2015-01-14 Published:2015-06-15 Online:2015-06-10
  • Contact: Yan-Bo ZHU E-mail:zhuyanbo2008@163.com

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摘要： 目的 探讨实时三维彩色多普勒经胸超声心动图 （RT-3D-CDTTE） 在结构性心脏病 （SHD） 外科手术前评估应用中的可行性及诊断价值。方法 应用 RT-3D-CDTTE 技术对 111 例患者进行术前评估， 其中 SHD 患者 31例， 非 SHD 患者 80 例作为阴性对照， 对比常规二维彩色多普勒经胸超声心动图 （2D-CDTTE）， 以心血管造影和术中直视所见为 “金标准”， 首先进行术前超声心动图检查及诊断， 然后追踪造影及手术结果， 以验证术前超声诊断的准确性。结果 （1） RT-3D-CDTTE 能够在术前清晰显示 SHD 病变的三维结构及血流动力学状态， 与心血管造影和术中直视所见基本一致。（2） 2D-CDTTE 对比 “金标准” McNemar 检验的 P 值大于 0.05， Kappa=0.654（P＜0.001）。RT-3D-CDTTE 对比 “金标准” McNemar 检验的 P 值大于 0.05,Kappa=0.932（P＜0.001）。结论 RT-3D-CDTTE 为 SHD外科手术前评价及决策提供了重要信息。

关键词: 超声心动描记术, 三维, 血流动力学, 经胸超声心动图, 结构性心脏病, 术前评价

Abstract: Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 patients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control.Conventional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT- 3DCDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D- CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P < 0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P < 0.001). Conclusion RT-3D-CDTTE can provides essential information for preoperative evaluation which is important for decision of SHD management.

Key words: echocardiography, three-dimensional, hemodynamics, transthoracic echocardiography, structural heart disease, preoperative evaluation