Saengsin Kwannapas, Intamul Kamonchanok, Sittiwangkul Rekwan
Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Int J Cardiovasc Imaging. 2025 May 21. doi: 10.1007/s10554-025-03426-6.
To evaluate the utility of three-dimensional transthoracic echocardiography (3D TTE) in the assessment and management of congenital heart disease (CHD). The use of three-dimensional TTE with both pediatric and adult patients has helped to clarify the cardiac anatomy and hemodynamic physiologic lesions in CHD. However, few practical aspects of 3D TTE have undergone systematic review. A retrospective study of CHD patients from January-December 2022 who underwent 3D TTE was conducted to determine the utility of 3D TTE with respect to answering the primary diagnostic question, adding diagnostic information to 2D imaging, concordance with 2D TTE or cardiac CT, and impact on management. During the study period, 76 CHD patients underwent 3D TTE at a median age of 104 months (IQR 29-175.5). The common cardiac segment under investigation was related to the atrioventricular valve. The mean heart rate was 89 ± 20 BPM. The mean volume rate was 17 ± 5. The single beat acquisition was used in all cases. Sedation use was infrequent (22.67%). Three-dimensional TTE answered the primary diagnostic question and added diagnostic information to 2D TTE imaging in all cases (100%). Additionally, 3D TTE impacted the management of the following: provided guided intervention (3/76, 4%), provided information before cardiac surgery (27/76, 36%), and increased understanding of the cardiac anatomy (76/76, 100%). Three-dimensional TTE can be applied in simple to complex CHD cases, across all age groups, from infants to adults. It provides real-time performance, requires no radiation, and infrequent use of sedation. This study showed that 3D TTE was accurate, answered the diagnostic questions in all cases, and frequently added diagnostic information that impacted management.
评估三维经胸超声心动图（3D TTE）在先天性心脏病（CHD）评估和管理中的效用。三维TTE在儿科和成人患者中的应用有助于明确CHD的心脏解剖结构和血流动力学生理病变。然而，三维TTE的一些实际应用方面尚未经过系统综述。对2022年1月至12月接受三维TTE检查的CHD患者进行回顾性研究，以确定三维TTE在回答主要诊断问题、为二维成像增加诊断信息、与二维TTE或心脏CT的一致性以及对管理的影响方面的效用。在研究期间，76例CHD患者接受了三维TTE检查，中位年龄为104个月（四分位间距29 - 175.5个月）。所研究的常见心脏节段与房室瓣有关。平均心率为89 ± 20次/分钟。平均容积率为17 ± 5。所有病例均采用单搏采集。镇静剂使用不频繁（22.67%）。三维TTE在所有病例（100%）中都回答了主要诊断问题，并为二维TTE成像增加了诊断信息。此外，三维TTE对以下管理方面产生了影响：提供引导性干预（3/76，4%）、在心脏手术前提供信息（27/76，36%）以及增强对心脏解剖结构的理解（76/76，100%）。三维TTE可应用于从婴儿到成人的所有年龄组，涵盖简单至复杂的CHD病例。它具有实时性，无需辐射，且镇静剂使用不频繁。本研究表明，三维TTE准确无误，在所有病例中都能回答诊断问题，并经常增加影响管理的诊断信息。
