实时三维超声心动图显示在诊断ALVT隧道样结构中的作用  

The value of real-time three dimensional echocardiography in clinical diagnosis of aortico-left ventricular tunnel

作　　者：金佳美[1] 张宇辉[1] 夏良华[1] 徐旻[1] 陈明[1] 

机构地区：[1]同济大学附属东方医院心脏医学部心超室,上海200120

出　　处：《医学影像学杂志》2013年第6期882-885,共4页Journal of Medical Imaging

基　　金：上海市浦东新区科技发展基金创新资金项目(PKJ2010-Y16);上海市浦东新区心血管疾病学科群(PWZxkq2010-01)

摘　　要：目的探讨实时三维超声心动图(RT-3DE)在诊断先天性心脏病主动脉-左室隧道(ALVT)上的影像特点。方法采集与分析4例ALVT患者的二维及三维超声心动图图像资料,ALVT的诊断由手术所见或心血管造影证实,应用RT-3DE评估ALVT患者的影像学特点。结果 4例患者2例经手术确诊,2例经造影确诊。依据Hovaguimian分型:I型2例(50%),Ⅱ型1例(25%),Ⅲ型1例(25%)。RT-3DE可见主动脉及左室流出道裂隙样异常管道,其中2例合并二叶主动脉瓣畸形。RT-3DE较二维超声更加容易捕捉ALVT畸形的管道样结构。结论 RT-3DE能够提供更为细致的解剖结构异常,增加术前诊断的准确性。Objective The purpose of the present study was to explore the imaging features in clinical diagnosis of aortico-left ventricular tunnel （AI.VT） by real-time three-dimensional echocardiography （RT-3DE）. Methods Two and three dimensional echocardiographic image data of 4 patients with ALVT were collected and analyzed. The diagnosis of ALVT was confirmed by surgical findings or angioeardiography. The imaging features of ALVT were evaluated by RT-3DE. Results The diagnoses were confirmed by surgery （2/4） or angiocardiography （2/4）. According to Hovaguimian classifica- tion, two cases were type I, 1 case was type H and 1 case was type III. The abnormal crack tunnel between aorta and left ventricular outflow tract could be recognized in all cases obviously by the RT-3DE. The bicuspid aortic valve was also ob served in 2 cases. The efficacy for catching up the tunnel-like features in patients with ALVT was improved using the RT 3DE compared with that by two-dimensional echocardiography. Conclusion The RT-3DE could provide more anatomic details about structure of the tunnel, which might have a potential effect on increasing accuracy in preoperative diagnosis of ALVT.

关 键 词：超声心动描记术 实时三维 主动脉-左室隧道 先天性心脏病 

分 类 号：R541.1[医药卫生—心血管疾病] R445.1[医药卫生—内科学]