经食管实时三维超声心动图在成人房间隔缺损封堵术前评估中的应用价值  

Application value of real-time three-dimensional transesophageal echocardiography in preoperative evaluation for transcatheter closure of adult atrial septal defects

作　　者：钟敏[1] 刘志东[1] 钟炜[1] 李奕琼[1] ZHONG Min;LIU Zhidong;ZHONG Wei;LI Yiqiong(Department of Ultrasound,Meizhou People’s Hospital,Guangdong 514031,China)

机构地区：[1]广东省梅州市人民医院超声科,514031

出　　处：《临床超声医学杂志》2019年第4期294-296,共3页Journal of Clinical Ultrasound in Medicine

基　　金：梅州市科技计划项目(2016B030)

摘　　要：目的探讨经食管实时三维超声心动图(RT-3D-TEE)在成人继发孔型房间隔缺损(ASD)封堵术前评估中的应用价值。方法选取23例有完整二维经胸超声心动图(2D-TTE)、经食管双平面成像(TEE-Xplane)和RT-3DTEE图像且行ASD介入封堵术的患者,观察ASD缺损口的形态、数量及其内部结构,测量ASD最大径、各方位的残缘及与腔静脉的距离。封堵术后分析ASD最大径测值与封堵器型号的平均绝对误差,评价不同成像方法测量的准确性。结果 23例患者中,15例ASD形态为椭圆形,3例为类圆形,1例为筛孔型,1例为复发型,3例为不规则型。经导管ASD封堵术成功21例,成功率91.3%。RT-3D-TEE测得的ASD最大径与封堵器直径的平均绝对差值为(2.57±1.96)mm,小于TEE-Xplane的(3.80±1.90)mm和2D-TTE的(4.96±2.82)mm,差异均有统计学意义(均P<0.05)。结论 RT-3D-TEE可为临床选择最佳封堵器型号提供可靠依据,具有较好的应用价值。Objective To investigate the application value of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE)in preoperative evaluation of adult secondary atrial septal defect(ASD).Methods Twentythree cases of ASD with complete 2D-TTE ,TEE-Xplane and RT-3D-TEE imaging were selected.All these patients had been performed with interventional occlusion.The morphology,quantity and internal structure of the ASD defect were observed,and the maximum diameter of the ASD,the shape of the defect and the residual of the various sites and the distance from the vena cava were measured.After the transcatheter ASD occlusion,the ACD maximum diameter measurement value and the average absolute error of the occluder model were analyzed to evaluate the accuracy of the three imaging methods.Results In 23 cases,15 cases of ASD were elliptical,3 cases were round,1 case was mesh type,1 case was recurrent ASD,and 3 cases were irregular.23 cases underwent transcatheter ASD occlusion,21 cases were successful(91.3%,21/23).The average absolute difference between the ASD maximum diameter and the occluder diameter measured by RT-3D-TEE was(2.57±1.96)mm,less than that of TEE-Xplane (3.80±1.90)mm,and 2D-TTE(4.96±2.82)mm,and the difference were statistically(both P<0.05).Conclusion RT-3D-TEE can provide reliable imforation for choosing occluder model in clinic,which has better application value.

关 键 词：超声心动描记术 实时 三维 经食管 房间隔缺损 成人 封堵术 

分 类 号：R540.45[医药卫生—心血管疾病] R541.1[医药卫生—内科学]