经胸二维和实时三维超声对人工心脏起搏器电极导线位置的观察

目的比较经胸二维和实时三维超声心动图在人工心脏起搏器电极导线位置定位中的应用价值。方法采用Philips公司Sonos7500型彩色超声心动图仪，经胸二维和实时三维超声心动图观察18例单腔或双腔人工心脏起搏器安置术后起搏电极导线在心腔内的行走路径、导线顶端嵌入位置以及起搏电极与三尖瓣及瓣下结构的关系。结果经胸二维超声能显示大部分患者起搏电极导线及导线顶端位置。经胸实时三维超声能清晰显示绝大部分患者起搏电极导线在心腔内的行走路径、导线顶端位置，更能立体直观显示电极导线与三尖瓣及瓣下结构的关系，结合实时三维彩色血流显像技术可观察有无三尖瓣返流及返流是否与电极导线有关。结论经胸二维和实时三维超声心动图作为对起搏器安置术后患者的随访观察有肯定的临床应用价值，实时三维超声较二维超声能更直观、准确地显示起搏电极导线在心腔内的位置、周邻关系及所致三尖瓣活动的改变，可望广泛应用于临床。

Locating pacemaker wire and lead by real - time three - dimensional echocardiography compared with conventional two- dimensional echocardiography

Objective To compare the value of real-time three-dimensional echocardiography(RT-3DE) with conventional two-dimensional echocardiography(2DE) in locating pacemaker wire and lead.Methods A total of 18 patients with permanent pacemaker implanted were examined by RT-3DE and 2DE to detect the pacemaker wire and lead.Results Most patients' pacemaker wires and leads could be detected by 2DE and RT-3DE.Not only the track of pace wire in right ventricle and right atrium but also the site of wire tip in myocardium could be clearly demonstrated by RT-3DE.RT-3DE also show the three-dimensional spatial relationship between pacemaker wire and tricuspid valve,and moreover,real-time three-dimensional color flow imaging(RT-3DCFI) could assess the degree and cause of tricuspid regurgitation.Conclusion The track of pacemaker wire and site of wire tip could be detected and located by RT-3DE more directly and easily than by 2DE.It is really useful for RT-3DE to display the three-dimensional spatial relationship of pacemaker wire and cardiac structure that can be expected to be used widely in pacemaker implantation.