经胸实时三维超声心动图在房间隔缺损介入治疗中的应用

目的：探讨实时三维超声心动图在房间隔缺损介入治疗中的应用价值。方法：采用Philips公司Sonos 7500型超声心动仪，实时三维超声心动图技术(real-time 3-dimensional echocardiography，RT-3DE)，部分结合二维食管超声心动图及放射检查技术引导临床5例先天性房间隔缺损的经导管介入治疗手术。结果：5例患者介入手术均获成功，术后无残余分流。RT-3DE在房间隔缺损的部位，大小，相对空间毗邻关系的判定均可获得比二维超声更丰富的数据信息，可靠性强。在引导介入手术中，无须全麻，操作简便，三维实时显像表现出良好的时问和空间分辨率，年龄限制少，一定程度上可减少放射应用剂量。术中实时测量三维距离，血流及多普勒技术的应用还受到技术制约。结论：经胸RT-3DE作为无创、无痛心脏检查手段在引导房间隔缺损的介入手术中有肯定价值，并可望广泛应用于其它介入治疗，其技术局限仍需进一步改进。

Transthoracic Real-time 3-dimensional Echocardiography Evaluation of Intervention in Atrial Septal Defect

Objective:To evaluate the role of real time 3 dimensional echocardiography (RT 3DE) in intervention of secundom atrial septal defect(ASD).Methods:ASD in 5 cases were closed with catheter intervention by the guidance of RT 3DE of echo machine Sonos 7500, transesophageal echocardiography(TEE )and radio x ray.Results:All the operation was successful and no resident shunt was present. RT 3DE could provide more information about the position, size and sufficient anatomic relationship of ASD than those of 2 dimensional echocardiography. In guided intervention procedures, RT 3DE has good identification of real time and position. In some situation, it could reduce radio dosages during operation. During application of RT 3DE, distance measurement, color and pulse Doppler techniques were still not allowed.Conclusions:RT 3DE technique has certain values in guided intervention of ASD and it may be used widely in the future, but in some cases, RT 3DE technique still need to be improved.