经胸三维超声心动图在复杂型先天性心脏病诊断中的应用价值  

Study on transthoracic three-dimensional echocardiographic diagnosis of complex congenital heart malformations in children

作　　者：陈国珍[1] 孙锟[1] 陈树宝[1] 张玉奇[1] 江海[1] 黄美蓉[1] 倪金洪[1] 沈蓉[1] 

机构地区：[1]上海第二医科大学附属新华医院上海儿童医学中心心内科,200127

出　　处：《中华超声影像学杂志》2002年第10期585-588,共4页Chinese Journal of Ultrasonography

基　　金：上海市教委"曙光计划"资助 (98SG40 )

摘　　要：目的　探讨三维超声剖视诊断小儿复杂型先天性心脏病 (先心病 )的临床应用价值。方法　用小儿心脏三维超声信息采集和剖视诊断方法对复杂型先心病进行三维剖视诊断 ,以造影和手术诊断为标准 ,与二维超声检查结果进行比较评价。结果　 118例复杂型先心病中有 10 8例 ( 92 .5 9%)获得较满意的三维重建图像 ,并在心室构型、心室大血管连接及室间隔缺损位置等心内结构判断上获得比二维超声更丰富的空间信息 ,从而纠正了二维超声诊断 17例 ( 15 .74%)。结论　三维超声剖视诊断能基本满足小儿复杂型先心病三维诊断要求 。Objective To evaluate the clinical utility of a new transthoracic three dimensional echocardiographic (3DE) acquisition of two dimensional (2D) images and vivi sectional diagnostic method for the diagnosis of complex congenital heart malformations in children.Methods One hundred and eighteen cases of children [72 male,46 female,mean aged ( 54.47 ± 48.17 ) months] with complex congenital heart malformations were diagnosed by the new designed 3DE method using HP Sonos 5500 echocardiographic system interfaced with TOMTEC image system.Their results were compared with those of 2D echocardiography.The results diagnosed by angiocardiography and operations were served as 'Gold Standard'.Results Three dimensional reconstruction was possible in 108 patients ( 92.59% ) with complex congenital heart malformation.In 17 patients ( 15.74% ),2DE diagnoses were partially corrected by 3DE providing additional spatial information and confirmed by angiocardiography and operations.The detail spatial information of inner cardiac structure was most useful,such as ventricular configuration identification,atrial ventricular and ventricular arterial continuity,location and shape of ventricular septal defects,and spatial appreciation of the defects related with great arteries, etc.Conclusions The new 3DE method could demonstrate detail spatial information of inner cardiac structure of complex congenital heart malformations in children,and the results were more informative than in 2D echocardiography.It is clinically feasible and useful.

关 键 词：经胸三维超声心动图 复杂型先天性心脏病 小儿 临床应用 诊断 

分 类 号：R540.45[医药卫生—心血管疾病] R725.411[医药卫生—内科学]