George Jon C, Varghese Vincent, Mogtader Allen
Cardiac Catheterization Laboratory, Deborah Heart and Lung Center, 200 Trenton Rd, Browns Mills, NJ 08015 USA.
J Ultrasound Med. 2014 Mar;33(3):387-95. doi: 10.7863/ultra.33.3.387.
Intracardiac echocardiography (ICE) uses a catheter-based steerable ultrasound probe that is passed into the right heart chambers to image intracardiac structures. The transducer can be variably positioned for optimal imaging: in the inferior vena cava to visualize the abdominal aorta; in the right atrium for the interatrial septum, aortic, mitral, and tricuspid valves, and pulmonary veins; or in the right ventricle for the left ventricular function, outflow tract, or pulmonary artery. Intracardiac echocardiography is primarily used for imaging during an invasive cardiac procedure using conscious sedation, when transthoracic image quality would likely be inadequate, and transesophageal imaging would require general anesthesia. Intracardiac echocardiography is generally well tolerated and provides adequate images and sufficient information for the procedure performed. In the cardiac catheterization laboratory, ICE is routinely used for patent foramen ovale, atrial septal defect, and ventricular septal defect closures, allowing adequate percutaneous placement of septal occluders. It is now being considered in the current era of transcatheter aortic valve implantation necessitating improved imaging approaches for accurate placement. It is also routinely used for trans-septal punctures during mitral valvuloplasty and, more recently, with the advent of left atrial appendage closure devices. This article provides a comprehensive review of the current technology for ICE and its growing applications in the realm of interventional cardiology.
心内超声心动图（ICE）使用基于导管的可操纵超声探头，该探头经送入右心腔以成像心内结构。换能器可进行不同位置的调整以获得最佳成像：置于下腔静脉以观察腹主动脉；置于右心房以观察房间隔、主动脉瓣、二尖瓣、三尖瓣和肺静脉；或置于右心室以观察左心室功能、流出道或肺动脉。心内超声心动图主要用于在使用清醒镇静的侵入性心脏手术期间成像，此时经胸图像质量可能不足，而经食管成像则需要全身麻醉。心内超声心动图通常耐受性良好，可为所进行的手术提供足够的图像和充分的信息。在心脏导管实验室中，ICE常规用于卵圆孔未闭、房间隔缺损和室间隔缺损封堵术，以确保经皮置入间隔封堵器的位置合适。在当前经导管主动脉瓣植入时代，由于需要改进成像方法以实现准确放置，ICE正受到关注。它还常规用于二尖瓣成形术期间的经间隔穿刺，以及最近随着左心耳封堵装置的出现而得到应用。本文对ICE的当前技术及其在介入心脏病学领域不断增长的应用进行了全面综述。
