实时三维超声心动图诊断结构性心脏病的应用价值

发布时间：2018-05-11 09:47

本文选题：三维超声心动图 + 心脏病　；参考：《军事医学》2015年10期

【摘要】：目的应用实时三维超声心动图(RT-3DE)技术,并通过与二维超声心动图(2DE)比较,探讨其在诊断结构性心脏病中的应用价值。方法选取2009年10月至2014年2月在南昌大学第一附属医院住院的92例心脏病患者,全部患者进行RT-3DE检查,通过对感兴趣区病变结构三维图像进行切割及旋转后处理作出诊断,同时对房间隔缺损(ASD)及室间隔缺损(VSD)大小进行测量分析,以外科手术结果为金标准,对比2DE与RT-3DE在结构性心脏病诊断率的一致性和差异,评价RT-3DE准确性和优越性。结果 (1)RT-3DE对92例心脏病患者均成功采集三维图像,对病变结构能立体、直观地从各个角度得到显示,正确诊断病变的部位、范围和程度及与邻近组织结构的空间位置关系,获得2DE无法得到的切面观,较2DE提供了更为直观而准确的信息。(2)在先天性心脏病中,RT-3DE诊断符合率与2DE相同;在瓣膜病及其他病变中,RT-3DE则稍高于2DE。(3)与2DE所测直径相比,RT-3DE所测ASD最大长轴径与手术结果具有更好的相关性(r值分别为0.94和0.86);RT-3DE所测VSD最大长轴径与手术结果具有更好的相关性(r值分别为0.93和0.84)。结论 RT-3DE操作简便,成像速度快,在结构性心脏病的诊断中可获得比2DE更丰富的空间信息,提高了诊断正确率,可作为2DE的有益补充,在结构性心脏病外科手术方案的制定上具有指导意义。
[Abstract]:Objective to evaluate the value of real-time three-dimensional echocardiography (RT-3DE) in the diagnosis of structural heart disease by comparing it with two-dimensional echocardiography (2DE). Methods 92 patients with heart disease were selected from October 2009 to February 2014 in the first affiliated Hospital of Nanchang University. All the patients were examined by RT-3DE, and the diagnosis was made by cutting and rotating 3D images of lesion structure in the region of interest. The size of atrial septal defect (ASD) and ventricular septal defect (VSD) were measured and analyzed. The accuracy and superiority of RT-3DE were evaluated by comparing the accuracy and difference of 2DE and RT-3DE in the diagnosis of structural heart disease. Results Third-dimensional images were collected successfully from 92 patients with heart disease by RT-3DE. The lesions were stereoscopically and intuitively displayed from various angles. The location, extent and extent of the lesions were correctly diagnosed, and the spatial relationship with the adjacent tissue structure was obtained. In congenital heart disease, the diagnostic coincidence rate of RT-3DE was the same as that of 2DE. In valvular diseases and other diseases, RT-3DE was slightly higher than 2DE.3DE) compared with the diameter measured by 2DE, the maximum long axis diameter of ASD measured by RT-3DE was better correlated with the operative results. The r values of RT-3DE were 0.94 and 0.86 respectively. The maximum length diameter of VSD measured by RT-3DE was better than that of operation. The good correlation r values were 0.93 and 0.84g, respectively. Conclusion RT-3DE has the advantages of simple operation and fast imaging. It can obtain more spatial information than 2DE in the diagnosis of structural heart disease, and improve the diagnostic accuracy. It can be used as a useful supplement to 2DE. It is of guiding significance in the formulation of surgical procedures for structural heart disease.
【作者单位】：南昌大学第一附属医院超声科;
【基金】：江西省科技厅科技支撑计划资助项目(2015BBG70225)
【分类号】：R540.45;R541

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