实时三维超声心动图对人工模拟房间隔缺损封堵的实验研究

目的评价实时三维超声心动图对人工模拟各种形态房间隔缺损(ASD)封堵的作用。方法采用医用乳胶片人工模拟20个各种形态ASD,用数码图片法、二维及实时三维超声心动图,观测其面积、长径及短径,并计算出三维面积代换内径。放置封堵器后用放射摄片法测量其面积及腰部最大径。将数码图片法及放射摄片法的测量值作为标准验证值。结果在14例以非类圆形为主(14/20)的模拟ASD中,二维超声测量的缺损长径小于数码图片法测量值,短径及计算面积大于数码图片法测量值,而三维超声心动图测量值与后者差异无统计学意义。对于各种形态的缺损封堵器释放后腰部均为类圆形。面积代换内径与放射摄片法测量封堵器释放后腰部最大径具有极高的相关性(Y=0.0828+0.97X,r=0.965,P0.0001)。结论在指导模拟ASD封堵实验中,实时三维超声心动图面积代换内径是较为准确的封堵器选择参数。

The study on assessment of precise closure of artificial atrial septal defect by experimental real-time three dimensional echocardiography

Objective To evaluate real-time three dimensional echocardiography （RT-3DE） on closure of the various morphous artificial atrial septal defect （ASD）. Methods Twenty morphous artificial ASD was made with medical emulsion slice. The area, long diameter and short diameter of twenty artificial ASD were measured by digital picture, 2D echocardiography and RT-3DE. Cycloidal dimension of substitution （CDS） was calculated. The waist size of occluder was measured after release by radio-photograph. Those results measured by digital picture and radio-photograph were served as gold standards. Results Among 20 artificial ASD, there were 14 cases （14/20） with non-round-like defects. All ASD long diameters measured by 2D echocardiography were smaller than those by digital picture, All ASD short diameter and area measured by 2D echocardiography were larger than those by digital picture without significant difference between RT-3DE and digital picture. In various morphous of ASD, the waist morphology of occluder was still round-like after release. The significant correlation was existed between the CDS of ASD measured by RT-3DE and the waist diameter of released occluder measured by radio-photograph（ Y =0. 0828 ＋ 0.97X,r = 0. 965,P 〈 0. 0001 ）. Conclusion The CDS of RT-3DE is a comparatively accurate parameter of selecting occluder on instruction of artificial ASD occlusion.