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目的探讨实时三维超声心动图(RT-3DE)对小儿常见先天性心脏病房间隔缺损(ASD)和室间隔缺损(VSD)的诊断价值及应用实时三维超声心动图小儿先天性心脏病的外科手术前后及介入治疗前后血流动力学的改变进行检测,以探讨其变化规律。方法用Philips iE33超声心动图诊断仪采集31例ASD患病儿童、46例VSD患病儿童及23例心脏正常结构和功能的儿童的EDV、ESV、SV、EF、SD等参数评价他们相应的心室容积和收缩功能。结果 (1)RT-3DE图像清晰、稳定,直观显示房、室间隔缺损的位置、类型、形态及其与周围结果的毗邻关系。(2)31例ASD术前或介入前1周和术后1周或介入后1个月EDv、Esv、sv、EF参数其检测值有显著差异(P值<0.01),术前或介入前1周和正常儿童EDv、Esv、sv、EF参数其检测值有显著差异(P值<0.01)。(3)33例VSD单向分流患儿的EDv、Esv、sv、EF参数术前1周和术后1个月检测值无显著差异(P值>0.01)。(4)13例VSD双向分流患儿的EDv、Esv、sv、EF参数术前1周和术后1个月检测值有显著差异(P值<0.01).13例VSD双向分流的术后1个月和正常儿童EDv、Esv、sv、EF参数检测值有显著差异(P值<0.01)。结论 RT-3DE与传统的二维超声相比能显示更多的房、室间隔的立体结构和房、室间隔缺损位置、形态,为临床提供了更多的间隔缺损信息,RT-3DE对心室收缩功能及在心室容积测量方面为临床提供了简便、可行、准确的新方法。
Objective To investigate the diagnostic value of real-time three-dimensional echocardiography (RT-3DE) in diagnosing atrial septal defect (ASD) and ventricular septal defect (VSD) in children with congenital heart disease and to evaluate the value of real-time three-dimensional echocardiography in congenital heart disease Before and after interventional hemodynamic changes were detected to explore its variation. Methods The parameters of EDV, ESV, SV, EF and SD of 31 children with ASD, 46 children with VSD and 23 children with normal heart function were collected by Philips iE33 echocardiography to evaluate their corresponding ventricles Volume and contractility. Results (1) The RT-3DE images clearly, stably and directly showed the location, type and morphology of atrioventricular septal defect and its adjacent relationship with the surrounding results. (2) There were significant differences in EDV, Esv, sv and EF between preoperative or preoperative 1 week and 1 week and 1 week or 1 month after intervention (P <0.01), preoperative or preoperative The values of EDv, Esv, sv and EF in 1 week and normal children were significantly different (P <0.01). (3) There was no significant difference in EDv, Esv, sv and EF parameters between the 33 cases of unidirectional VSD and the one week before operation and one month after operation (P> 0.01). (4) The EDV, Esv, sv and EF parameters of 13 patients with VSD with bilateral shunt were significantly different (P <0.01) one week before operation and one month after operation.Among the 13 cases of VSD, There was a significant difference in the measured values of EDv, Esv, sv and EF between months and normal children (P <0.01). Conclusion Compared with traditional two-dimensional ultrasound, RT-3DE can show more atrioventricular and interventricular septum structures and location of septal defect and morphology, providing more information of septal defect. Systolic function and ventricular volume measurement for the clinical provides a simple, feasible and accurate new method.