| 王庆慧,丁云川,尹帆,陈剑,苏璇,罗庆祎,张瑜,李建华.实时三维经食管超声心动图对特殊类型房间隔缺损治疗的风险评估[J].中国医学影像技术,2017,33(3):370~374 |
| 实时三维经食管超声心动图对特殊类型房间隔缺损治疗的风险评估 |
| Real-time three-dimensional transesophageal echocardiography intherapy risk assessment of unusual atrial septal defect |
| 投稿时间：2016-11-14 修订日期：2017-01-24 |
| DOI：10.13929/j.1003-3289.201611077 |
| 中文关键词: 超声心动描记术,经食管 成像,三维 心脏间隔缺损,心房 治疗 |
| 英文关键词:Echocardiography, transesophageal Imaging, three-dimensional Heart septal defects, atrial Therapy |
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| 中文摘要: |
| 目的 评价实时三维经食管超声心动图（RT-3DTEE）在临床治疗特殊类型房间隔缺损（ASD）风险评估中的应用价值。方法 对57例特殊类型ASD患者分别通过二维经胸超声心动图（2DTTE）、二维经食管超声心动图（2DTEE）及RT-3DTEE进行术前评估。观察ASD相关声像图表现，并对比三者对临床治疗的指导作用。结果 57例特殊类型ASD中，采用2DTTE及2DTEE对46例可清晰显示ASD的形态和数目，对其余11例仅能诊断ASD为不规则或两孔可能，而RT-3DTEE对57例均可直观显示ASD形态和数目。采用2DTTE、2DTEE及RT-3DTEE测量收缩末期左心房横径（LATD）、右心房横径（RATD）、右心室舒张末期内径（RVDD）、左心室舒张末期内径（LVDD）差异均无统计学意义（P均>0.05）；测量ASD的最大径（ASDD）时，2DTEE与2DTTE、RT-3DTEE与2DTTE差异均有统计学意义（P均<0.05）。3种方法测量ASD上腔静脉侧、主动脉侧及心房顶侧的残边长度总体差异均无统计学意义（P均>0.05）；3种方法测量ASD下腔静脉侧残边长度总体差异有统计学意义（F=50.39，P<0.001），两两比较差异均有统计学意义（P均<0.05）。通过RT-3DTEE对57例均可指导ASD治疗方式，而2DTTE对5例不能确定，2DTEE对2例不能确定。结论 RT-3DTEE可提供丰富的影像诊断信息，对特殊类型ASD治疗的风险评估具有重要指导意义。 |
| 英文摘要: |
| Objective To evaluate the application value of real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for the risk assessment of unusual atrial septal defect (ASD) in clinic therapy. Methods Accurate assessment before operation was conducted in 57 cases of patients with unusual ASD by two-dimensional transthoracic echocardiography (2DTTE), two-dimensional transesophageal echocardiography (2DTEE) and RT-3DTEE. The ultrasound manifestations were observed. And the guidance in clinic therapy were compared. Results The shape and number can be displayed clearly by 2D-TTE and 2D-TEE in 46 of 57 cases. Another 11 cases were diagnosed as irregular or two holes possibly. RT-3DTEE can help to observe the morphology and quantity of ASD visually and comprehensively in all cases. There was no statistical difference among 2DTTE, 2DTEE and RT-3DTEE for the measurement of right atrium end-systolic transverse diameter (RATD), left atrium end-systolic transverse diameter (LATD), right ventricular end-diastolic diameter (RVDD) and left ventricular end-diastolic diameter (LVDD; all P>0.05). The statistic difference for the diameter of atrial septal defect (ASDD) was found between 2D-TEE and 2D-TTE (P<0.05) and RT-3DTEE and 2D-TTE (P<0.05). There was no statistical difference among 2D-TEE, 2D-TTE and RT-3DTEE for the measurement of residual boundary condition of superior vena cava, aorta side and the top side of the atrium (all P>0.05), whereas significant difference was found in measuring the residual boundary condition of inferior vena cava (F=50.39, P<0.001). There were statistic differences between 2DTEE and 2DTTE, RT-3DTEE and 2DTTE, RT-3DTEE and 2DTEE (all P<0.05). The clinic therapy can be directed by RT-3DTEE in all 57 cases. The diagnosis of 5 cases was failed by 2D-TTE, and 2 cases was failed by 2D-TEE. Conclusion Abundant image information can be offered by RT-3DTEE which plays an important role in the risk assessment of unusual atrial septal defect. |
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