房间隔缺损的经胸多平面三维超声心动图剖析诊断研究

目的:探讨影响继发孔房间隔缺损(ASD)经胸三维超声心动图(3DTTE)重建的采样途径和三维剖析诊断方案。方法:选取ASD 21例,应用经胸多平面探头分别在胸骨旁、心尖部和剑突下采集图像,脱机三维重建,利用任意剖切功能,显示ASD及周边结构,测量缺损最大长轴径和短轴径。结果:20例ASD三维重建成功。从右房侧正对房间隔选择性剖切,正面动态成像了ASD完整的形状和在房隔的空间部位,除心尖部外,余部位采样测量ASD大小与手术测值均具有高度相关性。额面四腔顺序剖切能较好地观察ASD与周边结构的关系。结论:3DTTE能理想重建ASD,右房侧剖切剖视能完整显示ASD,结合额面四腔心剖视有利于ASD解剖分型。

Transthoracic dynamic three-dimensional echocardiography in atrial septal defects: methods and clinical application

Objective:To investigate the influence of different approaches of acquisition on three-dimensional reconstruc-tion of atrial septal defect(ASD)by transthoracic three-dimensional echocardiography(3DTTE),and to define the feasible image processing and display in ASDs.Methods:21pediatric patients with ASDs were studied.Image acquisition for 3DTTE was carried out with transthoracic Omniplane rotational probe,which was placed in parasternal,apical and subcostal position respectively.Three-dimensional(3D)reconstruction was then performed and the optimal enface views of ASDs and anatomic relationship of the defects and other structures were displayed by using Tomtec4D Cardio-View RT software.Diameters of ASDs at the major axis and the minor axis were measured directly.Results:20patients with ASDs were rendered successfully.On RA cutting plane to enface view,dynamic morphology,shapes,and positions of ASDs were displayed.Except for apical approach,diameters at major axis and the minor axis on3DTTE were excellently correlated with those on surgery.On 4-chamber cutting view with sequence slice function,the relationship of ASD and anatomic structures nearby could be revealed clearly on3D in some cases.Conclusion:3DTTE could provide spatial presentation of various types of ASDs.The size and shape of ASD can be accurately determined from right-side cutting plane,and the anatomic types of ASD can be distinguished as well when combined with4-chamber cross section.