Hsu Jong-Hau, Wu Jiunn-Ren, Dai Zen-Kong, Lee Meng-Hsun
Division of Pediatric Cardiology, Department of Pediatrics, Kaohsiung Medical University and Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Pediatrics, University of California, San Francisco, California, USA.
Int J Cardiol. 2007 Jun 12;118(3):326-31. doi: 10.1016/j.ijcard.2006.08.006. Epub 2006 Oct 24.
Real-time three-dimensional echocardiography (RT3DE) is a new image modality, and it can display a unique image reconstruction in a variety of heart diseases. However, clinical assessment of ventricular septal aneurysm (VSA) by RT3DE has not been reported. This pilot prospective study is to survey what kinds of new insights of VSA can be provided by RT3DE as compared with conventional 2-dimensional echocardiography (2DE).
We investigated the diagnostic value of RT3DE and 2DE in 60 consecutive patients with VSA. From different transthoracic windows, structures of interest can be displayed from any orientation through adjusting cropping and slicing the RT3DE datasets. The results were compared with those in 2DE.
RT3DE reconstruction of VSA was feasible in 56 of 60 patients (93%). When compared with 2DE, additional information provided by RT3DE included blood flow through left ventricle to right ventricle, visualization of VSD enface border in 56 patients (93%), morphology of the VSA from apical short axis view in 48 patients (86%), hypertrophied margin of the interventricular septum in 26 patients (43%), dynamic changes of VSA and tricuspid valve in 18 patients (30%), adhesion of chordae tendineae in VSA in 16 patients (26%).
Structures of interest can be evaluated from unique RT3DE in any orientation during scanning. RT3DE offers additional novel views and has the advantages of not only displaying better visualization of VSA, but also adequately showing the spatial relationship with its adjacent structures. It can provide novel and useful anatomic insights than 2DE while assessing patients with VSA.
实时三维超声心动图（RT3DE）是一种新的成像方式，它能够在多种心脏疾病中呈现独特的图像重建。然而，RT3DE对室间隔瘤（VSA）的临床评估尚未见报道。这项前瞻性初步研究旨在探究与传统二维超声心动图（2DE）相比，RT3DE能为VSA提供哪些新的见解。
我们对60例连续的VSA患者研究了RT3DE和2DE的诊断价值。从不同的经胸窗，通过调整裁剪和切割RT3DE数据集，可以从任何方向显示感兴趣的结构。将结果与2DE的结果进行比较。
60例患者中有56例（93%）可行VSA的RT3DE重建。与2DE相比，RT3DE提供的额外信息包括左心室向右心室的血流、56例患者（93%）室间隔缺损正面边界的可视化、48例患者（86%）心尖短轴视图中VSA的形态、26例患者（43%）室间隔肥厚边缘、18例患者（30%）VSA和三尖瓣的动态变化、16例患者（26%）VSA中腱索的粘连。
在扫描过程中，可以从独特的RT3DE以任何方向评估感兴趣的结构。RT3DE提供了额外的新颖视图，不仅具有更好地显示VSA的优点，还能充分展示其与相邻结构的空间关系。在评估VSA患者时，它比2DE能提供新颖且有用的解剖学见解。
