Marx G R, Fulton D R, Pandian N G, Vogel M, Cao Q L, Ludomirsky A, Delabays A, Sugeng L, Klas B
Tufts University School of Medicine, Boston Floating Hospital for Infants and Children, New England Medical Center, Massachusetts 02111.
J Am Coll Cardiol. 1995 Feb;25(2):482-90. doi: 10.1016/0735-1097(94)00372-w.
This study attempted to determine the site, relative size and dynamic geometry of atrial septal defects using dynamic three-dimensional echocardiography.
Recent studies have demonstrated the feasibility of dynamic three-dimensional echocardiography. Images are acquired from computerized reconstruction of sequential, tomographic ultrasound "slices" of the heart. Ultrasound images can be obtained by linear progression of a transducer within a transesophageal imaging probe. In small infants and children the large transducer size has not allowed transesophageal placement, and the probe has been placed on the thorax or in the subcostal position. Other scanning devices, housed in plastic containers, acquire images in a rotational format and can also be placed in a transthoracic or subcostal position.
Specially designed transesophageal probes and a dedicated computer unit were used for two-dimensional image retrieval and reconstruction of three-dimensional images. Sixteen patients with atrial septal defects were studied (median age 18 months, range 1 day to 18 years). In one patient, images were obtained by transesophageal probe placement; in the other 15 patients, the probe was placed in the transthoracic or subcostal position.
A dynamic three-dimensional echocardiogram of the atrial septal defect could be obtained in 13 of the 16 patients. The distinguishing features of the atrial septal defects and their spatial orientation could be visualized in unique three-dimensional views.
Dynamic three-dimensional imaging could be applied to the specific evaluation of atrial septal defects. Unique views of the heart allowed for spatial comprehension of the defects, rendering potentially important clinical information.
本研究试图利用动态三维超声心动图确定房间隔缺损的部位、相对大小和动态几何形状。
近期研究已证实动态三维超声心动图的可行性。图像通过对心脏的连续断层超声“切片”进行计算机重建获取。超声图像可通过经食管成像探头内换能器的线性移动获得。在婴幼儿中，由于换能器尺寸较大，无法经食管放置，探头一直放置在胸部或肋下位置。其他装在塑料容器中的扫描设备以旋转方式获取图像，也可放置在经胸或肋下位置。
使用专门设计的经食管探头和专用计算机单元进行二维图像采集和三维图像重建。对16例房间隔缺损患者进行了研究（中位年龄18个月，范围1天至18岁）。1例患者通过经食管放置探头获取图像；其他15例患者中，探头放置在经胸或肋下位置。
16例患者中有13例获得了房间隔缺损的动态三维超声心动图。房间隔缺损的特征及其空间方位可在独特的三维视图中清晰显示。
动态三维成像可用于房间隔缺损的具体评估。心脏的独特视图有助于对缺损进行空间理解，提供潜在重要的临床信息。
