心脏右室双出口的三维超声诊断  

Transthoracic Three-dimensional Echocardiographic Diagnosis of Double Outlet Right Ventricle

作　　者：陈国珍[1] 孙锟[1] 陈树宝[1] 张玉奇[1] 江海[1] 

机构地区：[1]上海第二医科大学附属新华医院,上海儿童医学中心心内科,上海市200127

出　　处：《中国超声医学杂志》2003年第11期821-824,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :初步评价三维超声心动图剖视诊断右室双出口 (DORV)的临床应用价值。方法 :以心导管造影和手术结果为标准 ,对 2 8例心脏右室双出口进行三维超声剖视诊断 (5剖切面、 10剖视面 ) ,并与二维超声结果进行比较。结果 :5剖切面、 10剖视面方案能显示右室双出口心内和大血管根部结构而能满意诊断 2 6例(92 .86% ) ,其中正对室间隔的 L 1a、 L 2 a剖视面显示室缺位于主动脉下 13例 ,肺动脉下 5例 ,双动脉下 2例及远离大动脉 6例 ,从而补充 2 DE诊断 5例 (19.2 3 % )。在 18例手术中 ,发现 3 DE对室缺内径测量与手术测值相关性 (r=0 .88,P<0 .0 0 0 1)明显高于 2 DE (r=0 .72 ,P<0 .0 0 1) ,且对室缺面积测量也与所测内径呈高度相关(r=0 .95,P<0 .0 0 0 1)。结论Objective:To evaluate the feasibility a nd potential value of our new three-dimensional echocardiographic (3DE) vivi-s ectional diagnostic method for the diagnosis of double outlet right ventricle (D ORV) Methods:Using HP sonos 5500 echocardiographic syste m and Tomtec image system under electrocardiographic and respiratory gating,28 c ases of children with DORV (16 male,12 female,mean aged 39 36±39 77 months,we ight 11 81±6 14 kg) were diagnosed by the new designed 3DE method The result s were compared with those of 2DE Angiocardiographic and post-operative diagno sis were served as 'Gold Standard' Results:3DE vivi-sect ional diagnosis showed two great vessels of DORV mainly originated from right ve ntricle and relative to other intracardiac structures such as the interventricul ar septum and the atrioventricular valve,etc Especially,en cross sectional view s of ventricular septum from the left or right ventricular side,L1a or L2a displ ayed the location and entire shape of interventricular septal defect,which could be helpful to determine the morphologic types of DORV and methods of surgical r epair From our findings,three-dimensional reconstruction was diagnosed in 26 p atients (92 86%),which included 13 cases of interventricular septal defect loca ted under aorta,5 under pulmonary,2 near to and 6 far from the two great arterie s Among them,another 5 patients (19 23%) diagnosed by 2DE were partially corre cted by 3DE and confirmed by angiocardiography and operations According to conr esponding intraoperative findings in totally 18 patients,the correlation of 3DE measuring diameters of interventricular septal defect versus those by surgery ( r =0 88, P <0 000 1) was higher than those by 2DE versus surgery ( r = 0 72, P <0 001) There was also an excellent correlation between the diamet er of interventricular septal defect and its area measured by 3DE ( r =0 95, P <0 000 1) Conclusions:Three-dimensional echocardi ographic vivi-sectional diagnosis can provide additional spa

关 键 词：诊断 右室双出口 三维超声 室缺 心脏 视诊 切面 剖视 显示 内径 

分 类 号：R445.1[医药卫生—影像医学与核医学]