实时三维超声心动图在先天性心脏瓣膜病诊断中的临床价值

目的：探讨实时三维超声心动图（RT-3DE）诊断先天性心脏瓣膜病的可靠性、优越性及其临床应用价值。方法：对20例先天性心脏瓣膜病患者行经胸超声心动图（TTE）及RT-3DE检查,观察心脏瓣膜病变的范围、程度,病变与瓣上或瓣下结构的关系,并与外科手术结果对比TTE与RT-3DE对病变诊断符合率的一致性和差异。结果：①RT-3DE可形象、立体、多角度地显示心脏瓣膜及其瓣上瓣下结构的真实形态,从而发现一些TTE难以发现的病变。②RT-3DE对先天性心脏瓣膜病诊断符合率稍高于TTE。③TTE和RT-3DE检查结果一致（Kappa=0.615,P〈0.05）。结论：RT-3DE在先天性心脏瓣膜病的诊断中可获得比TTE更丰富的空间信息,是TTE的有益补充。

THE CLINICAL VALUE OF REAL-TIME THREE-DIMENSIONAL ECHOCARDIOGRAPHY IN CONGENITAL CARDIAC VALVULAR DISEASES

Objective：To evaluate the accuracy and superiority of the application of real-time three-dimensional echocardiography（RT-3DE） in patients with congenital cardiac valvular diseases,and to explore the clinical value.Methods：Twenty patients with congenital heart valve disease underwent transthoracic echocardiography（TTE） and RT-3DE to observe the rang and degree of heart valves lesions,as well as the relation to the neighbour structure.The difference and consistency of diagnostic accordance rate between RT-3DE and TTE were checked by the results of surgery.Results：①RT-3DE can show the heart valve and its neighbor relationship from many angles of view which could not be found by TTE.②The diagnostic accordance rate in RT-3DE was a little higher than that in TTE.③The examination results of TTE were consistent with RT-3DE（Kappa value=0.615,P〈0.05）.Conclusion：RT-3DE can provide more spatial information than TTE in the diagnosis of congenital cardiac valvular diseases and offer a useful complement to TTE.