全容积三维超声心动图在小儿室间隔缺损诊治中的应用价值  

The value of full-volume three-dimensional echocardiography in diagnosis and treatment of children ventricular septal defect

作　　者：杨慧[1] 朱琦 王宏桥[1] 裴彩英[3] 

机构地区：[1]青岛大学附属医院超声科,山东青岛266000 [2]四川大学华西第二医院超声科,四川成都610041 [3]聊城市人民医院超声科,山东聊城252000

出　　处：《西部医学》2017年第12期1733-1737,共5页Medical Journal of West China

基　　金：四川省科技厅科技支撑计划项目(2011SZ0099);(2014ZR0209)

摘　　要：目的探讨全容积三维超声心动图(FV3DE)在测量小儿室间隔缺损的最大值与造影测值及封堵伞直径间的差异性、相关性和一致性。方法将满足条件的35例室间隔缺损患者,分别进行二维(2D)及全容积三维超声图像的采集、数据分析与对比。结果不同超声方法的室间隔缺损最大测值与封堵伞直径、造影测值之间均无明显差异(P>0.05);2DE、FV3DE测值与造影测值相关系数分别为r=0.617(P<0.05)、r=0.781(P<0.05);FV3DE测值与封堵伞直径相关系数为r=0.411(P<0.05);2DE测值与封堵伞直径无明显相关性(P=0.075);Bland-Altman法分析:造影与2DE测值的差值,有15.2%(5/33)的点在95%一致性界限以外,造影与FV3DE测值差值,仅6.1%(2/33)的点在95%一致性界限以外;封堵伞直径与2DE测值差值,有12.1%(4/33)的点在95%一致性界限以外;封堵伞直径与FV3DE测值差值,仅有6.1%(2/33)的点在95%一致性界限以外。观察VSD发现最大面积出现在收缩早期,最小面积出现在收缩末期。结论全容积实时三维超声心动图能够较准确评估室间隔缺损的形态及大小,可以为临床治疗提供更全面的资料,有利于促进VSD封堵术的开展。Objective To reseavch the value of full-vocume of three-dinlensional echocor diography in diagnosis and treafmenf of children ventricular sepfal defecf. Methods 35 patients with ventricular septal defect were treated with two dimensional （2D） and full volume three--dimensional ultrasound. The clinical data were analyzed. Results There were no statistical differences between the two group of measurements and ventriculography or the diameter of occluder respec- tively （P〉0.05）. FV3DE had a better relation with the ventriculography （r：0. 781, P〈0.05） than 2DE （r=0. 617, P 〈0.05）. FV3DE had a moderate relation with the diameter of occluder （r=0. 411, P〈0.05）. There were no relations between the results measured by 2DE and the diameter of the occluder （P=0. 075）. There were 5 of 33 points（15.2%） were out of the 95% limits of agreement in the difference between ventriculography and 2DE. However, of difference be- tween ventriculography and FV3DE, there were only 2 of 33 points （6.1%）were out of the 95 % limits of agreement. In the difference between the diameter of occluder and 2DE, the points out of the 95 ~//00 limits of agreement were account for 12. 1%（4/33）. However, there were 2 of 33 points （6.1%） were out of the 95% limits of agreement in the difference between the diameter of occluder and FV3DE. The area of VSDs appeared maximal in the early systolic phase and mini- mal in the end-systolic phase. Conclusion Full volume real-time three-dimensional echocardiography can accurately assess the shape and size of the ventricular septal defect and provide more comprehensive information for clinical treatment.

关 键 词：全容积 三维超声心动图 室间隔缺损 

分 类 号：R540.45[医药卫生—心血管疾病]