实时三维超声心动图在房间隔缺损封堵术中监测引导封堵器置入的初步临床研究  

Real-time Three-dimensional Echocardiographic Monitoring and Guidance During Transcatheter Closure of Atrial Septal Defect:Preliminary Study

作　　者：吕秀章[1] 朱振辉[1] 王剑鹏[1] 刘延玲[1] 王浩[1] 姚铮[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院超声科,北京市100037

出　　处：《中国超声医学杂志》2006年第9期678-680,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨实时三维超声心动图（RT一3DE）在继发孔型房间隔缺损（SASD）经导管房间隔封堵术（TCASD）术中监测引导Amplatzer封堵器（ASO）置入的临床应用价值。方法术前经临床及超声筛选符合TCASD适应证的SASD患者20例，男7例，女13例，年龄5～12岁，平均（5．2±4．O）岁。在TCASD术中以RT-3DE（Live3D模式和Full Volume模式）和TT-2DE监测引导AS0的置入。结果SASD缺损大小为8～14mm，平均（10±5．0）mm，所用AS0型号为12～20mm，平均（14．5±4．8）mm，所有患者均顺利成功封堵，房水平分流消失。经胸Live3D模式下从不同的角度实时动态显示ASO的位置、形态和缺损周围残余房间隔组织被夹于左右房伞之间以及ASO与缺损周围结构的关系。Full—Volume模式图像采集快速，重建图像清晰，所有图像均清晰完整显示AS0位置、形态以及与缺损周边毗邻结构的关系。结论RT-3DE在TCASD术中可以实时监测引导AS0的置入和释放，协助TCASD术中AS0的置入。Objective To assess the value of real-time three-dimensional echocardiography （RT-3DE） in deployment of Amplatzer septal occluder （ASO） during transcatheter closure of atrial septal defect （TCASD） procedure. Methods Twenty patients （male 7, female 13） indicated for TCASD according to the RT-3DE and TT- 2DE examination were studied, aged from 5-12 years （mean age 5.2＋4.0 years） .All patients were with sinus rhythm. During the TCASD procedure, RT-3DE （Live 3D mode and Full-Volume mode） images of the ASO were obtained using a 4 MHz 4 X matrix probe. Results The size of the SASDs was 8-14 mm （10±5.0 mm）, and the size of ASOs was 12-20 mm （14.5±4.8 mm） . All ASOs were deployed successfully in all patients under the monitoring and guidance of RT-3DE and TT-2DE. Complete closure were achieved in all patients. The RT-3DE images of ASO were clear and smooth in all patients, including the shape, position and spatial relations with adjacent structures. Conclusions The placement of ASO could be monitored and guided by RT-3DE successfully and optimally during TCASD procedure.

关 键 词：实时三维超声心动图 继发孔型房间隔缺损 AMPLATZER房间隔封堵器 

分 类 号：R725.4[医药卫生—儿科]