三维经食管超声心动图与其他影像技术指导左心耳封堵术的对比

发布时间：2018-02-11 23:34

本文关键词： 左心耳心房颤动超声心动描记术经食管　出处：《中国医学影像技术》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨三维经食管超声心动图(3D-TEE)和2D-TEE、CTA和术中X线造影在左心耳(LAA)形态、大小评估及指导封堵器型号选择方面的价值。方法对43例拟行LAA封堵术的心房颤动患者行TEE,清晰显示LAA并于0°、45°、90°和135°分别测量其开口最大径和最大深度值;于LAA显示最清晰切面启动3D-ROOM模式测量开口最大径、最小径,并将其与2D-TEE、CTA和X线造影的检查结果进行对比。结果 3D-TEE测量LAA开口最大径与2D-TEE、术中X线造影测值差异无统计学意义(P均0.05),CTA测量LAA开口最大径明显大于3D-TEE、2D-TEE和X线造影测值(P0.01);2D-TEE于90°和135°测量LAA最大深度值与CTA测值差异有统计学意义(P均0.05),与术中X线造影比较,仅在135°时差异有统计学意义(P0.01)。3D-TEE测量LAA开口最大径与2D-TEE各角度、CTA和X线造影测值呈明显正相关(r=0.70~0.77、0.57、0.58,P均0.01);2D-TEE各角度测量LAA开口最大径与CTA、X线造影测值均存在相关性(r=0.57~0.71,0.45~0.51;P均0.01);3D-TEE、2D-TEE、CTA及X线造影LAA开口最大径与封堵器大小均呈明显正相关且(r=0.93、0.70~0.77、0.57、0.47,P均0.01)。结论 3D-TEE与2D-TEE、CTA和X线造影相比,3D-TEE对于封堵器大小的选择更具指导性。
[Abstract]:Objective to investigate the morphology of three-dimensional transesophageal echocardiography (3D-TEE), 2D-TEECTA and intraoperative radiography in left atrial appendage (LAA). Methods 43 patients with atrial fibrillation who were scheduled to be occluded by LAA were treated with TEE. The LAA was clearly displayed and the maximum diameter and depth of the opening were measured at 0 掳45 掳90 掳and 135 掳respectively. Start the 3D-ROOM mode to measure the maximum diameter and minimum diameter of the opening in the LAA display. Results 3D-TEE measured the maximum diameter of LAA opening and 2D-TEE. There was no significant difference in intraoperative radiography between CTA and 2D-TEE. Results the maximum diameter of LAA in 3D-TEE was significantly larger than that of 3D-TEE2D-TEE and X-ray. The maximum depth of LAA measured at 90 掳and 135 掳was significantly different from that of CTA (P < 0.05), and was compared with that of intraoperative radiography. There was a significant correlation between the maximum diameter of LAA openings measured by 3D-TEE and 2D-TEE at all angles and X-ray radiography only at 135 掳. There was a significant correlation between the maximum diameter of LAA openings measured at 0. 01 掳and 3D-TEE 2D-TEE at all angles and the value of CTA by X-ray radiography (P = 0. 051) and the values of CTA measured by X-ray radiography were 0. 01D TEE 2D-TEE 2D TEE 2D TEECTA and 0. 707 D TEE 2D-TEECTA, respectively. There was a significant correlation between the maximum diameter of LAA openings and the value of CTA measured by X-ray radiography. There was a significant correlation between the maximum diameter of LAA openings and the value of CTA measured by X-ray radiography. Conclusion 3D-TEE is more instructive in the choice of occluder size than that in 2D-TEE CTA and X-ray radiography, and there is a significant positive correlation between the maximum opening diameter of LAA and the size of occluder in X-ray radiography, and the size of occluder is 0.97 ~ 0.70 ~ (0.70) ~ (0.77) ~ 0.47 ~ 0 ~ (7) ~ 0. Conclusion 3D-TEE is more instructive to the choice of occluder size than that of 2D-TEE CTA and X-ray radiography.
【作者单位】：四川省医学科学院四川省人民医院心血管超声及心功能科;
【分类号】：R540.45;R654.2

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