Gutleben Klaus-Jürgen, Nölker Georg, Lironis Nikitas, Günther Jens
Klinik für Kardiologie Herz- und Diabeteszentrum NRW, Universitätsklinik der Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland.
Herzschrittmacherther Elektrophysiol. 2012 Dec;23(4):260-8. doi: 10.1007/s00399-012-0235-5. Epub 2012 Dec 5.
During recent years the need for intraprocedural imaging has increased. Fluoroscopy and angiography are frequently supplemented by pre-procedural magnetic resonance or computed tomography imaging as well as electroanatomic mapping techniques. However, poor real-time imaging quality of soft tissue, radiation exposure, and contrast media consumption are disadvantageous. Ultrasound techniques are characterized by high-quality imaging of soft tissue that can be obtained in real time. All relevant anatomical structures and their relationships to catheters can be evaluated at any time during the procedure. Moreover, functional analysis, e.g., flow measurements and monitoring for complications, is possible. Transesophageal and especially intracardiac echocardiography (ICE) contribute enormously to effectiveness and safety of complex procedures. ICE has been shown to be useful in transseptal procedures like atrial fibrillation ablation but also in ablation procedures for ventricular tachycardias.
近年来,术中成像的需求有所增加。荧光透视和血管造影术经常辅以术前磁共振或计算机断层扫描成像以及电解剖标测技术。然而,软组织实时成像质量差、辐射暴露和造影剂消耗是不利因素。超声技术的特点是能够实时获得高质量的软组织成像。在手术过程中的任何时候都可以评估所有相关的解剖结构及其与导管的关系。此外,还可以进行功能分析,如流量测量和并发症监测。经食管超声心动图,尤其是心内超声心动图(ICE)对复杂手术的有效性和安全性有很大贡献。ICE已被证明在诸如房颤消融等经间隔手术中有用,也在室性心动过速的消融手术中有用。