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实时三维超声心动图评价先天性心脏病形态结构的初步探讨

时间:2005-09-06 19:22:13  来源:  作者:

Department of ultrasound Diagnosis, Union hospital, Tongji Medical College ofHuazhong University of Science and Technology <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

             ABSTRACT
  Objective: To explore the value and methods of real-time three-dimensional echocardiography (RT3DE) in evaluation of abnormal heart anatomyof congenital heart diseases.
  Methods: 26 patientswithcongenitalheartdisease (including 7 patients with ASD, 8 VSD, 1 ASD andPDA1doubleoutletventricle, 1 endocardiac cushion defect, 1 tetralogy of Fallot, 1 quinalogy of Fallot, 2 ASD after operation and 4 VSD after operation) were examined with RT3D. Both "Live 3D" and "Full volume" modes of RT3DE were used in obtaining best visualization of three-dimensional heart anatomy. 3DE images were compared with 2DE images, and some 3DE images were compared with operation view. 
  Results: 1.RT3DE produced novel views of congenital heart defects and offered improved visualization of complex cardiac anatomy relationship. 2.Comparing with 2DE, RT3DE could display the spatial view of deeper structure. 3.In patients accepted operation, RT3DE images were quite similar to the operation view. 4.RT3DE showed dynamic features of defects in the congenital heartdisease.
  Conclusions: Comparing with 2DE, RT3DE provided additional spatial and temporal information of cardiac anatomy in congenital heart diseases without extending examining time. It has good potential in clinical use of congenital heart disease diagnosis and differentiating diagnosis.
  Key words: Echocardiography, Real-time Three-dimensional Echocardiography; Congenital; Heart Disease
  长期以来,在先天性心脏病的诊断与疗效评估上,人们一直期望能获得类似手术视野观的三维影像资料。但目前在临床上,无论是有创性心血管造影检查方法,还是无创性的超声心动图、MRI检查方法,都只能在二维平面上或心脏的某一剖切面上来显示先天性心脏病(先心病)的复杂结构关系。临床医生只能凭借不同方位或剖面的二维影像资料来想象出先心病的复杂空间解剖关系,其局限性显而易见。最近,一种基于探头技术革新和计算机三维图像显像技术改进的新技术--实时三维超声心动图已应用于临床[1]。我们利用此项技术对先心病的病变解剖结构进行了观察,将初步经验总结如下:

              资料与方法
  一、研究对象
  先天性心脏病患者26例,男12例,女14例,年龄46天48岁,平均16.5±12.9岁。其中房间隔缺损7例,室间隔缺损8例,房间隔缺损合并动脉导管未闭1例,右室双出口1例,心内膜垫缺损1例,法洛氏四联症1例,法洛氏五联症1例,术后6例(房缺修补术后2例,室缺修补术后4例)。均为窦性心率。

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