Ortiz E, Robinson P J, Deanfield J E, Franklin R, Macartney F J, Wyse R K
Br Heart J. 1985 Jul;54(1):53-60. doi: 10.1136/hrt.54.1.53.
Precise non-invasive localisation of the site of a small ventricular septal defect was attempted using a new technique that simultaneously combines conventional cross sectional echocardiography with a Doppler system by superimposing the colour coded direction and velocity of blood flow directly on to real time ultrasound images. Twenty three patients with unoperated ventricular septal defects and a further eight after surgical closure were studied; 12 children with normal hearts served as controls. A colour coded blood flow jet entering the right ventricle during systole was identified in all 23 unoperated patients, in 11 of whom the defect was too small to be visualised by conventional cross sectional echocardiography. The colour Doppler technique precisely located 19 perimembranous and five trabecular defects (one patient had two defects). Five of the postoperative patients were without clinical evidence of a significant shunt but had pansystolic murmurs. In each of these five, trans-septal shunt blood flow as demonstrated by colour Doppler images whereas in only three of these patients was the residual defect large enough to be visualised by conventional cross sectional echocardiography. Three postoperative patients had no murmurs and showed no residual shunt on colour Doppler images. This was confirmed at cardiac catheterisation. There were no false positive results among the controls. This technique is useful for the more accurate diagnosis and location of ventricular septal defects and may help in assessing their natural or surgical closure.
采用一种新技术对小型室间隔缺损部位进行精确无创定位，该技术通过将血流的彩色编码方向和速度直接叠加到实时超声图像上，将传统的横断面超声心动图与多普勒系统相结合。研究了23例未经手术治疗的室间隔缺损患者以及另外8例手术闭合后的患者；12例心脏正常的儿童作为对照。在所有23例未经手术治疗的患者中均发现了收缩期进入右心室的彩色编码血流喷射，其中11例患者的缺损太小，无法通过传统横断面超声心动图显示。彩色多普勒技术精确地定位了19个膜周部缺损和5个小梁部缺损（1例患者有2个缺损）。5例术后患者无明显分流的临床证据，但有全收缩期杂音。在这5例患者中，彩色多普勒图像均显示有跨间隔分流血流，而其中只有3例患者的残余缺损大到足以通过传统横断面超声心动图显示。3例术后患者无杂音，彩色多普勒图像显示无残余分流。心脏导管检查证实了这一点。对照组中没有假阳性结果。该技术有助于更准确地诊断和定位室间隔缺损，并可能有助于评估其自然闭合或手术闭合情况。
