实时三维超声心动图检查在先天性二叶式主动脉瓣畸形患者诊断中的应用价值  

The Value of Real-time Three-dimensional Echocardiography in the Diagnosis of Patients with Congenital Aortic Valve Diastolic Malformation

作　　者：袁冬冬 张慧珍 YUAN Dong;ZHANG Huizhen(Department of Ultrasound,Kaifeng People's Hospital,Kaifeng Henan 475000,China)

机构地区：[1]开封市人民医院超声科,河南开封475000

出　　处：《临床研究》2023年第7期120-123,共4页Clinical Research

摘　　要：目的探讨实时三维超声心动图(RT-3DE)检查应用于先天性二叶式主动脉瓣(BAV)的价值。方法选取2020年2月至2022年2月开封市人民医院收治的99例BAV患者,并按照随机原则选取99例同期健康体检者,均行经胸二维超声心动图(2DE)检查及RT-3DE,以“手术确诊”为金标准。统计BAV患者、健康体检者主动脉狭窄及主动脉瓣关闭不全情况、BAV患者不同分型主动脉内径比较、RT-3DE、2DE检查诊断结果。结果BAV患者跨瓣压差、返流分数、返流束宽/左室流出速度、返流束面积/左室流出道面积大于健康体检者,开放程度、瓣口面积小于健康体检者,差异有统计学意义(P<0.05)。经手术确诊,99例BAV患者中,有18例Type 0型、81例Type 1型、0例Type 2型;其中有30例Type 1 R-N型、51例Type 1 L-R型。Type 1型中R-N型、L-R型患者主动脉窦部、瓣环内径大于Type 0型患者,且Type 1型中L-R型患者主动脉窦部大于R-N型患者;RT-3 DE检出率、横裂式、斜裂式、纵裂式大于2 DE,差异有统计学意义(P<0.05)。结论与健康体检者比较,BAV患者经RT-3DE检查效果优于2DE检查,可用于评估不同分型主动脉内径,为临床诊断提供准确参考。Objective To explore the value of real-time three-dimensional echocardiography(RT-3DE)in the diagnosis of congenital bicuspid aortic valve(BAV).Methods A total of 99 patients with BAV in Kaifeng People's Hospital(from February 2020 to February 2022)and 99 healthy check-ups at the same time were selected according to the randomization principle,all patients underwent transthoracic two-dimensional echocardiography(2DE)examination and RT-3DE,with"surgical confirmation"as the gold standard.Statistics of aortic stenosis and aortic valve insufficiency in patients with BAV and healthy subjects,comparison of aortic internal diameters in different types of BAV patients,RT-3DE and 2DE diagnosis results.Results The cross-valve pressure difference,regurgitation fraction,regurgitant bundle width/left ventricular outflow velocity and regurgitant bundle area/left ventricular outflow tract area were greater in BAV patients than in healthy subjects,and the degree of opening and orifice area were less than in healthy subjects,with statistically significant differences(P<0.05);among the 99 BAV patients with surgically confirmed diagnosis,18 were Type 0,81 were Type 1 and 0 were Type 2.Among them,30 were Type 1 R-N and 51 were Type 1 L-R.Type 1 patients with R-N and L-R aortic sinus and annulus diameters greater than Type 0;further comparison showed that L-R Type patients in Type 1 had a greater aortic sinus size than R-N Type patients;the detection rate of RT-3DE,transverse split,oblique split,longitudinal split are higher than 2DE,he difference is statistically significant(P<0.05).Conclusion Compared with healthy subjects,patients with BAV had greater transvalvular pressure difference,regurgitant fraction,regurgitant bundle width/left ventricular outflow velocity,regurgitant bundle area/left ventricular outflow tract area,smaller openness and orifice area by RT-3DE,and different fractal aortic internal diameters,and the detection rate was higher than that by 2DE,which can provide accurate reference for clinical diagnosis.

关 键 词：实时三维超声心动图 二维超声心动图 BAV 诊断价值 

分 类 号：R445[医药卫生—影像医学与核医学]