动态三维超声心动图定性、定量诊断复杂型先天性心脏病的研究  

Qualitative and quantitative study on complex congenital heart disease with dynamic three dimensional echocardiography

作　　者：庞玉生[1] 经承学[1] 刘唐威[2] 郭盛兰[1] 何巍[2] 

机构地区：[1]广西医科大学第一附属医院儿科,南宁530021 [2]广西医科大学第一附属医院心血管病研究所

出　　处：《广西医学》2006年第7期974-976,共3页Guangxi Medical Journal

基　　金：广西壮族自治区教育厅科研项目(桂科教研〔2002〕316号)。

摘　　要：目的探讨动态三维超声心动图(3DE)诊断复杂型先天性心脏病的应用价值。方法对复杂型先天性心脏病患儿42例应用HP5500型彩色多普勒超声心动图仪采集二维数据,在TOMTEC计算机工作站进行三维重建,然后应用圆盘总和法测量左室舒张末期容积(LVEDV)、收缩末期容积(LVESV)、每搏量(LVSV)及射血分数(EF),同时应用二维超声心动图(2DE)Simpson法测量了上述指标。28例应用心导管检查(Fick)测量了左室每搏量,30例患儿接受手术治疗。结果所有患儿均获得满意的三维图像,能清晰显示心内膜、二尖瓣、三尖瓣及主动脉瓣,准确显示心血管三维空间解剖畸形。应用3DE测得LVEDV、LVESV、LVSV、EF分别为(42·6±8·2)ml、(16·5±3·4)ml、(27·3±7·8)ml、(64·2±6·4)%,与2DEC(Simpson法)的测值相比相关性良好(r值分别为0·85、0·86、0·84及0·82,P均<0·001),2DE测量结果偏低,但两者比较差异无统计学意义(P>0·05)。2DE(Simpson法)所测LVSV与心导管(Fick法)所测结果呈中度相关(r=0·83,P<0·001),而经胸3ED(disk-summation)所测LVSV与心导管检查所测结果呈高度相关(r=0·95,P<0·001)。结论2DE、3DE均可用于检测复杂型先天性心脏病,后者比前者能提供更丰富的诊断信息,测量结果更准确。Objective To evaluate the three dimensional echocardiography clinical value on diagnosing complex congenital heart diseases.Methods Two dimensional data were studied using HP 5500 color Doppler ultrasound scanner in 42 children with complex congenital heart diseases.Three dimensional echocardiography（3DE） was performed at TOMTEC station.Then the left ventricular end-systolic volume（LVEDV） and end-diastolic volume（LVESV） were measured in these cases from each three dimensional echocardiographic data set with the ＂disk summation＂ method. Stroke volume（LVSV） and ejection fracfion（LVEF） were then derived. AU above data were also measured using Simpson method from two dimensional echocardiography（2DE） .The LVSV was also measured using Fick method from cardiac catheterization in 28 cases.30 cases underwent surgical repair. Results Satisfactory 3DE imaging were acquired in all patients to deafly display endocardium, mitral valve, tricuspid valve, aortic valve and the cardiovascular three dimensional anatomic malformation. 3DE provided more abundant diagnosing information than 2DE.The LVEDV,LVESV,LVSV and LVEF from 3DE were（42.6±8.2）ml,（16.5±3.4）m1,（27.3 ±7.8）m1,（64.2 ± 6.4） %, respeetivdy, which showed excellent correlation with those measured with Simpson method（ r = 0.85,0.86,0.84 and 0.82, respectively, P 〈 0.001, respectively ）. The results from 2DE were lower than that from 3DE but with no significant differences between them （ P 〉 0.05）. There were closer limits of agreement between 3DE and Fick for LVSV（ r = 0.95） than that between 2DE echocardiography and Fick（ r = 0.83）. Condusion 2DE and 3DE can be used to evaluate complex congenital heart disease. 3DE can provide abundant diagnosing information and is highly reliable in measuring.

关 键 词：超声心动图 三维超声心动图 先天性心脏畸形 

分 类 号：R725.411[医药卫生—儿科]