【摘要】 目的对缺损的大小和形态学特征的准确评估,是房间隔缺损(ASD)临床决策至关重要的信息;然而,二维超声心动图(2DE)常规切面难以显示ASD的整个缺损口的形态,本研究探讨特殊的2DE切面显示ASD形态学特征的全貌和ASD与周边结构的空间关系。方法2DE常规切面诊断237例成人继发孔型ASD,再使用房间隔切面显示ASD完整的平面形态学特征。比较任何一个常规切面测量的ASD最大直径和房间隔切面显示完整的ASD平面的情况下测量ASD最大直径。结果220/237例(92.8%)患者使用胸骨旁房间隔切面成功地显示ASD的整个缺损平面,其中单个缺损口的194例患者,常规切面与房间隔切面显示的ASD最大直径的差异有非常显著的统计学意义(P<0.001),2种方法测量的最大直径呈直线相关,相关系数有高度显著性(r=0.935,P<0.001)。胸骨旁房间隔切面能显示ASD的大小、形状、边缘情况及与周边结构的空间关系,也能显示2个或2个以上缺损口之间的关系。结论作者首次提出使用经胸2DE胸骨旁房间隔切面能清晰显示ASD完整的平面图像,提供ASD的大小、形状、位置及周边关系的信息,如此精确的显像对临床决策和确定是单个或多个缺损具有重要的意义。更多还原

【Abstract】 Objective The precise assessment of defect size and shape is of paramount important information for the clinical decision of atrial septal defect (ASD).However,the morphologic features of ASD are difficult to be imaged on two-dimensional echocardiography with the conventional sections.Therefore,this study sought to find a special two-dimensional echocardiographic section providing en face plan view of ASD and spatial orientations to the neighboring structures.Methods A total of 237 patients with the secundum ASD were determined by conventional two-dimensional echocardiographic sections.The major diameter of ASD was the maximal one measured on any conventional section.Then en face plan view of ASD was showed by the interatrial septal section.When the interatiral septal section showed en face plan view of ASD,the major diameter could be measured.Results The interatiral septal section was visualized successfully en face plan view of ASD in 220/237(92.8%) patients.The major diameter of ASD measured by the interatrial septal section was significantly larger than those of the conventional sections (P<0.001) in 194 patients with singular defect.There was a good linear correlation between the conventional and interatrial septal sections for ASD major diameter (r=0.935,P<0.001).The interatrial septal section allowed the assessment of the size,shape,cirumference and spatial orientations to the neighboring structures of ASD.It also allowed to evaluate the spatial relationship between two or multiple defects in patients with ASD.Conclusions This is the first presentation that the interatiral septal section obtained from transthoracic two-dimensional echocardiography can provide the overall morphologic features such as the size,shape and position of ASD.The precise imaging will provide such beneficial informations as making clinical decision and determining singular or multiple defects.更多还原