实时三维经食管超声心动图在房间隔缺损中的诊断价值  

Value of Real-Time Three-Dimensional Transesophageal Echocardiography in the Diagnosis of Atrial Septal Defect

作　　者：孙菲菲[1] 任卫东[1] 张颖[1] 马春燕[2] 王欣[1] 曲冉[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,沈阳市110004 [2]中国医科大学附属第一医院心功能科

出　　处：《中国超声医学杂志》2011年第10期952-955,共4页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省自然科学基金(No.20082106)

摘　　要：目的探讨实时三维经食管超声心动图(RT3D-TEE)对房间隔缺损(ASD)的诊断价值。方法 36例ASD患者分别行二维经食管超声心动图(2DTEE)和RT3D-TEE检查。评价ASD的解剖特征并测量相关数据,将所得结果进行对比分析。结果 36例患者中,31例(86.1%)获得了可供对ASD进行完整形态学观察及测量的满意图像,诊断为继发孔型ASD 19例;原发孔型ASD 3例,其中2例合并二尖瓣前叶裂;静脉窦型ASD 1例,为上腔静脉型;筛孔型ASD 3例;卵圆孔未闭5例。并有7例合并房间隔膨出瘤。2DTEE和RT3D-TEE测得ASD最大径分别为(21.4±12.7)mm和(21.7±12.6)mm(P>0.05)。应用RT3D-TEE可清晰显示ASD多为椭圆形或不规则形,近圆形较少,并能实时、快速观察ASD残缘状况、缺损大小及随心动周期的变化。结论 RT3D-TEE能更科学、直观地评价ASD的形态特征及与毗邻结构的空间关系,在ASD的诊断及指导治疗方面具有重要的临床应用价值。Objective To explore the value of real-time three-dimensional transesophageal echocardiography （RT3D-TEE）in the diagnosis of atrial septal defect（ASD）. Methods Two-dimensional transesophageal echocardio- graphy（2DTEE）and RT3D-TEE were performed in 36 patients with the ASDs. Morphologie evaluation and relevant measurements obtained on RT3D-TEE were compared with those obtained on 2DTEE. Results Among the 36 studies, optimal 3D images for both the morphologic evaluation and measurements of ASD were obtained in 31 patients （86. 1%）. There were 19 patients with secundum ASD^3 with primum ASD, 2 were associated with a cleft in anterior mitral leaflet;1 with sinus venosus ASD, was attributed to the superior vena cava type;3 had multiple defects;5 with patent foramen ovale and 7 combined with interatrial septal aneurysm. The mean maximum diameter was（21.4± 12.7） mm using 2DTEE compared to （21.7 ±12.6）mm using RT3D-TEE（P〉 0.05）. RT3D-TEE imaging clearly demon- strates that these ASDs were frequently not perfectly circular, but often oval or irregular in shape. In addition, we can also appreciate that the rim and size of an ASD varies throughout the cardiac cycle. Conclusions RT3D-TEE enhances the diagnosis and therapeutic selection of ASD, is more clinical useful for displaying the morphology of defect and its spatial relationship with neighboring structures.

关 键 词：超声心动描记术 三维 实时 经食管 房间隔缺损 

分 类 号：R540.45[医药卫生—心血管疾病] R541[医药卫生—内科学]