经食管实时三维超声心动图评估房间隔缺损对封堵器选择的指导价值  

Application Value of Real-Time 3D Transesophageal Echocardiography in Occluder Device Selecting of Atrial Septal Defect

作　　者：翁育娟[1] 陈薇[1] 林国钦[2] 蒋燕萍 彭纪龙 Weng Yujuan;Chen Wei;Lin Guoqin;Jiang Yanping;Peng Jilong(Department of Ultrasound,Affiliated Hospital of Putian University,Putian,Fujian351100,China;Department of Cardiology,Affiliated Hospital of Putian University,Putian,Fujian351100,China)

机构地区：[1]莆田学院附属医院超声科,福建省莆田市351100 [2]莆田学院附属医院心内科,福建省莆田市351100

出　　处：《中国超声医学杂志》2023年第2期162-165,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨经食管实时三维超声心动图(RT-3D-TEE)评估成人房间隔缺损(ASD)对封堵器选择的指导价值。方法 行介入封堵治疗的房间隔缺损患者41例,术前测量二维经胸超声心动图(2D-TTE)、二维经食管超声心动图(2D-TEE)及RT-3D-TEE的ASD最大径(ASD_(TTE)、ASD_(TEE)、ASD_(3D))、RT-3D-TEE的ASD面积,并计算圆形面积代换直径(ASD_(D))。介入封堵成功后,在数字减影血管造影(DSA)机下测量封堵器伸展径(OSD)。结果 在各种ASD形态中,形态以非类圆形为主(78%)。在类圆形ASD中,ASD_(TTE)、ASD_(TEE)、ASD_(3D)及ASD_(D)分别与OSD的差异均无统计学意义(P>0.05)。但在非类圆形ASD中,ASD_(TTE)、ASD_(TEE)小于ASD_(3D)及OSD,差异均有统计学意义(P<0.05),ASD_(3D)大于OSD,差异有统计学意义(P<0.05),而ASD_(D)与OSD差异无统计学意义(P>0.05)。总体ASD中,ASD_(D)与OSD显著相关(r=0.93,P<0.01),ASD_(TTE)、ASD_(TEE)、ASD_(3D)与OSD有较强相关性,分别为:y=0.75x±6.35,r=0.78,P<0.05;y=0.83x±5.14,r=0.82,P<0.05;y=0.85x±3.31,r=0.83,P<0.05。39例患者封堵成功,无严重并发症。结论 ASD_(D)可为临床选择封堵器型号提供更准确的参考依据。Objective To explore the value of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE) in adult atrial septal defect(ASD) evaluating and selection of occlusion device. Methods 41 patients with atrial septal defect who planned interventional closure therapy were selected. The ASD maximum diameter of 2D-TTE(two-dimensional transthoracic echocardiography), 2D-TEE(two-dimensional transesophageal echocardiography), and RT-3D-TEE(ASD_(TTE), ASD_(TEE), ASD_(3D)),and the area of RT-3D-TEE were measured, and the replacement diameter of the circular area was calculated(ASD_(D)). After successful transcatheter closure, the occluder stretched diameter(OSD) was measured by digital subtraction angiography. Results ASD morphology was mainly non-nearly circular(78%). In nearly circular ASD, there was no significant difference between ASD_(TTE), ASD_(TEE), ASD_(3D), ASD_(D)and OSD(P>0.05). However, in non-nearly circular ASD, ASD_(TTE)and ASD_(TEE)was smaller than ASD_(3D)and OSD, and the differences were statistically significant(P<0.05). ASD_(3D)was larger than OSD, the difference was statistically significant(P<0.05). But there was no significant difference between ASD_(D)and OSD(P>0.05). In ASD overall, ASD_(D)was significantly correlated with the OSD(y=1.02x±2.42, r=0.93, P<0.01). The correlation between OSD and the ASD_(TTE), ASD_(TEE), ASD_(3D)was strong, which was y=0.75x±6.35,r=0.78,P<0.05;y=0.83x±5.14,r=0.82,P<0.05;y=0.85x±3.31,r=0.83,P<0.05, respectively. 39 patients were successfully occluded without serious complications. Conclusions The replacement diameter of the ASD circular area measured by RT-3D-TEE can provide reference more accurately in occluder type selection.

关 键 词：经食管实时三维超声心动图 房间隔缺损 封堵器 

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