Binder T, Globits S, Zangeneh M, Gabriel H, Röthy W, Koller J, Glogar D
2nd Department of Internal Medicine/Division of Cardiology, University of Vienna, Austria.
Eur Heart J. 1996 Apr;17(4):619-28. doi: 10.1093/oxfordjournals.eurheartj.a014917.
Appreciation of three-dimensional relationships could be useful in cardiac diagnosis, decision making and planning of surgery. However, current ultrasound techniques provide only two-dimensional views. A recently developed echocardiographic computerized tomography unit allows reconstruction of three-dimensional images from a series of transoesophageal slices. To evaluate the potentials and limitations of this technique we performed echo computer tomographic examinations in 104 patients with a total number of 227 scans. All but two patients tolerated the procedure well and no serious complications were encountered. Indications for echo computer tomography included coronary artery disease, valvular heart disease, atrial masses, myocardial infarction, mitral and aortic valve replacement, aortic aneurysm and congenital defects. Most of the anatomical structures could be visualized with the best results obtained for the left atrium, the left ventricular outflow tract and the aortic and mitral valve apparatus. However, a variety of technical factors must be considered to achieve optimal results and to avoid misinterpretation. In 86% of patients the underlying pathology could be visualised by echo-computed tomography, particularly congenital defects such as those of the atrial or ventricular septa, but mitral valve pathologies provided the best results. In these cases three-dimensional imaging led to a better perception and understanding of structural relationships. In conclusion, despite current limitations in data acquisition, processing and computing power, echo computer tomography has the potential to provide relevant information in selected clinical settings.
了解三维关系可能有助于心脏疾病的诊断、决策制定和手术规划。然而，目前的超声技术仅提供二维图像。最近开发的超声心动图计算机断层扫描装置能够从一系列经食管切片重建三维图像。为了评估该技术的潜力和局限性，我们对104例患者进行了超声计算机断层扫描检查，共进行了227次扫描。除两名患者外，所有患者对该检查耐受良好，未出现严重并发症。超声计算机断层扫描的适应证包括冠状动脉疾病、心脏瓣膜病、心房肿物、心肌梗死、二尖瓣和主动脉瓣置换、主动脉瘤和先天性缺陷。大多数解剖结构都能被清晰显示，其中左心房、左心室流出道以及主动脉和二尖瓣装置的显示效果最佳。然而，为了获得最佳结果并避免错误解读，必须考虑多种技术因素。在86%的患者中，潜在病变能够通过超声计算机断层扫描清晰显示，尤其是先天性缺陷，如房间隔或室间隔缺损，但二尖瓣病变的显示效果最佳。在这些病例中，三维成像能更好地呈现和理解结构关系。总之，尽管目前在数据采集、处理和计算能力方面存在局限性，但超声计算机断层扫描有潜力在特定临床情况下提供相关信息。
