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[三维超声心动图的当前临床应用]

[Current clinical applications of three-dimensional echocardiography].

作者信息

Badano Luigi P, Aruta Patrizia, Nguyen Kim, Palermo Chiara, Baritussio Anna, Cecchetto Antonella, Previtero Marco, Figliozzi Stefano, Genovese Davide, Guta Andrada C, Ochoa-Jimenez Roberto C, Parati Gianfranco, Muraru Denisa

机构信息

Dipartimento di Scienze Cardiovascolari, Neurologiche e Metaboliche, Istituto Auxologico Italiano, IRCCS, Ospedale S. Luca, Milano - Dipartimento di Medicina e Chirurgia, Università di Milano-Bicocca, Milano.

Dipartimento di Scienze Cardiache, Toraciche, Vascolari e Sanità Pubblica, Università degli Studi, Padova.

出版信息

G Ital Cardiol (Rome). 2019 Dec;20(12):722-735. doi: 10.1714/3271.32381.

Abstract

Three-dimensional echocardiography (3DE) represents one of the most innovative advances in cardiovascular imaging over the last 20 years. Recent technological developments have fueled the full implementation of 3DE in clinical practice and expanded its impact on patient diagnosis, management, and prognosis. One of the most important clinical applications of transthoracic 3DE has been the quantitation of cardiac chamber volumes and function. The main limitations affecting two-dimensional echocardiography calculations of chamber volumes (i.e. geometric assumptions about cardiac chamber shape and view foreshortening) are overcome by 3DE that allows an actual measurement of their volumes. Transesophageal 3DE has been applied mainly to assess the anatomy and function of heart valves, congenital defects and masses in the beating heart. As reparative cardiac surgery and transcatheter procedures have become more and more popular to treat structural heart disease, transesophageal 3DE has become not only one of the main imaging modalities for procedure planning but also for intra-procedural guidance and assessment of procedural results. New image rendering modalities such as 3D printing, holographic display, and fusion of 3DE images with other radiological or nuclear modalities will further expand the clinical applications and indications of 3DE.

摘要

三维超声心动图(3DE)是过去20年中心血管成像领域最具创新性的进展之一。最近的技术发展推动了3DE在临床实践中的全面应用,并扩大了其对患者诊断、管理和预后的影响。经胸3DE最重要的临床应用之一是对心腔容积和功能进行定量分析。3DE克服了影响二维超声心动图心腔容积计算的主要局限性(即关于心腔形状的几何假设和视图缩短),能够实际测量心腔容积。经食管3DE主要用于评估心脏瓣膜的解剖结构和功能、先天性缺陷以及跳动心脏中的肿块。随着修复性心脏手术和经导管手术越来越广泛地用于治疗结构性心脏病,经食管3DE不仅已成为手术规划的主要成像方式之一,还用于术中指导和手术结果评估。新的图像渲染方式,如3D打印、全息显示以及3DE图像与其他放射学或核医学方式的融合,将进一步扩大3DE的临床应用和适应证。

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