复杂型先天性心脏病实时三维超声病理形态学诊断方法研究  

Study of Real-time Three-dimensional Echocardiographic DiagnosticMethod of Pathological Morphology in Complex Congenital Heart Disease

作　　者：陈国珍[1] 黄国英[1] 孙锟[2] 梁雪村[1] 陈笋[2] 陈树宝[2] 

机构地区：[1]复旦大学附属儿科医院心血管中心,上海市200032 [2]上海第二医科大学附属上海儿童医学中心心内科

出　　处：《中国超声医学杂志》2006年第1期1-4,共4页Chinese Journal of Ultrasound in Medicine

基　　金：中国博士后科学基金资助(No.2004036113)

摘　　要：目的探索建立复杂型先天性心脏病(CHD)实时三维超声(RT-3DE)病理形态学剖视诊断方法,并评价其应用价值。方法12头正常猪、52例术前及18例术后复杂型CHD经RT-3DE检查后,用5剖切面10剖视面方案和CHD顺序分段诊断步骤进行RT-3DE剖视诊断分析,结果与二维超声、猪心解剖直视及CHD手术诊断比较。结果12头猪均获满意的RT-3DE显示,5剖切面、10剖视面的RT-3DE剖视诊断结果与其解剖直视下相同切面及视角剖切所见一致。70例CHD获254次Full Volume采样,其中,77.17%能良好显示心脏及大血管根部立体结构及其周邻关系,44.49%能显示全部10个剖视面。追踪52例术前病例手术结果,27例手术,RT-3DE补充二维超声诊断5例,占18.52%。结论系统的RT-3DE剖视诊断结合节段分析可满足复杂型CHD心脏三维病理形态学诊断要求,有助于促进该技术的临床规范化应用。Objective To establish the real-time three-dimensional echocardiographic （RT-3DE） sectional diagnostic method of pathological morphology in complex congenital heart disease （CHD） and evaluate initially its clinical value. Methods Twelve pigs, seventy patients with complex CHD including fifty-two preoperative and eighteen postoperative patients were examined by RT-3DE such as Live-3D and Full Volume, etc. Their examinations of pathological morphology were diagnosed by the diagnostic method of our ten designed 3DE sectional views and Van Praagh＇s sequential segmental approach in CHD. Then their results were compared with those of two-dimensional echocardiography （2DE）, those of the similar anatomic sectional view of porcine hearts, those of surgical findings of complex CHD. Results Images in the twelve porcine hearts were well displayed by RT 3DE. The ten designed 3DE sectional views of RT-3DE were confirmed to the similar sectional anatomic views of the hearts. In the seventy patients with complex CHI）, there were 254 image acquisitions of ＂ Full volume＂ ~ Among them, 77.17% could demonstrate good spatial cardiovascular structures arrd other neighboring spatial relationship, and 44.49% could display clearly all ten 3I）E sectional views. Meanwhile, among 27 patients undergoing operations in the fifty-two preoperative patients, there were 5 patients （18.52%） of 2DE diagnosis partially corrected by RT-3DE, through displaying spatial cardiovascular malformations and providing additional diagnostic information. Conclusions RT- 3DE could make a successfully sectional diagnosis of pathological morphology in complex CHD.

关 键 词：复杂型先心病 三维超声心动描记术 实时三维剖视诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]