经胸实时三维超声心动图指导房间隔缺损封堵器选择  

Value of transthoracic real-time three dimensional echocardiography on selecting occluder of atrial septal defect

作　　者：刘利勋[1] 张军[1] 李军[1] 刘丽文[1] 

机构地区：[1]第四军医大学西京医院超声诊断科,西安710032

出　　处：《中华超声影像学杂志》2009年第2期132-135,共4页Chinese Journal of Ultrasonography

基　　金：国家科技支撑计划“常见先心病、瓣膜病介入治疗技术规范、远期疗效及新技术临床应用研究”资助课题（2007BA105B03）

摘　　要：目的评价经胸实时三维超声心动图（RT-3DE）指导房间隔缺损（ASD）封堵器选择的临床应用价值。方法30例ASD患者，术前应用二维经胸超声心动图观测ASD大小及周缘情况，RT3DE及彩色RT-3DE观察ASD形态，测量ASD面积及最大径，并计算出圆形面积代换内径。封堵器释放后测量其面积及腰径。结果ASD以非类圆形为主22例（73．3％）。在各种ASD形态中，封堵器释放后腰部形态仍为类圆形，其面积与RT-3DE及彩色RT-3DE所测量ASD面积差异无统计学意义（P〉0．05）。二维测量ASD内径小于封堵器释放后腰径，RT-3DE测量ASD最大内径大于封堵器释放后腰径，但圆形面积代换内径与封堵器释放后腰径差异无统计学意义（P〉0．05）。ASD圆形面积代换内径与封堵器大小（Y＝0．29＋1．132X，r=0．93，P〈0．0001）及释放后封堵器腰径（Y=-0．160＋1．063X，r=0．98，P〈0．0001）显著相关。所有患者ASD封堵器牢固无脱落。结论经胸RT-3DE在指导ASD封堵器选择中有肯定价值。Objective To evaluate clinical application of transthoracic real-time three-dimensional echocardiography（RT 3DE） on selecting oeeluder of the atrial septal defect（ASD）. Methods ASD size and its rim of thirty patients with ASD were measured by transthoracie two-dimensional echocardiography（2DE） on various views before occlusion. ASD was reconstructed by transthoracic RT-3DE and color RT-3DE. The images were studied in multiple orientations and cross sections, including the morphology, area, longest diameter,and cyeloidal dimension of substitution（CDS） was calculated. The waist size of occluder was measured after releasing occluder. Results Among 30 cases of ASD, there were 22 cases（73.30%） with now roundqike defects. In various morphous of ASD,the waist morphology of occluder still was round-like after releasing occluder. There was no significant difference between waist area of occluder and measured area of ASD by RT-3DE and color RT 3DE. All ASD diameters measured by 2DE were smaller than the dimension of waist after releasing, ASD longest diameters measured by RT-3DE and color RT-3DE were larger than the dimension of waist after releasing,but were no significant differences with CDS. Significant correlation was existed between the CDS of ASD measured by RT 3DE and the size of selected occluder （ Y = 0.29 ＋ 1. 132 X , r = 0.93, P d0. 0001）,and the waist size of released occluder（ Y = - 0. 160 ＋ 1. 063 X , r = 0.98, P 0. 0001）. Occluder was firmly fixed without falling off in all patients. Conclusions Transthoracic RT 3DE has certain value on selection of ASD occluder.

关 键 词：超声心动描记术 实时三维 房间隔缺损 临床应用 

分 类 号：R686[医药卫生—骨科学]