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目的探讨实时三维超声心动图(RT-3DE)观察先天性双孔二尖瓣畸形(DOMV)的应用价值。方法5例先天性DOMV患者,在常规二维超声心动图基础上,应用RT-3DE实时显像、全容积显像及彩色成像模式,观察畸形二尖瓣立体形态及血流动力学改变。结果5例先天性DOMV中,3例合并部分型房室间隔缺损,2例为单纯性双孔二尖瓣;2例合并有瓣裂,无瓣裂者3例;5例患者均伴有不同程度的二尖瓣关闭不全(中-重度3例,轻度1例,功能正常1例)。术前二维超声提示3例DOMV,漏诊2例(其中1例术后复查时提示)。实时三维超声提示4例DOMV,1例术前未行实时三维超声检查,术后复查时提示。结论与二维超声心动图比较,实时三维超声心动图能更全面、立体地显示二尖瓣的空间结构,提高对DOMV诊断的准确性,可作为传统二维超声心动图的重要补充。
Objective To investigate the value of real-time three-dimensional echocardiography (RT-3DE) in the observation of congenital mitral valve defects (DOMV). Methods Five cases of congenital DOMV were treated with RT-3DE real-time imaging, total volume imaging and color imaging mode based on conventional two-dimensional echocardiography. The morphological and hemodynamic changes of mitral valve were observed. Results In 5 cases of congenital DOMV, 3 cases were complicated with partial atrioventricular septal defect, 2 cases were simple double-hole mitral valve, 2 cases were complicated with valvular dehiscence, 3 cases without valvular fractures, 5 cases were all different The degree of mitral regurgitation (moderate - severe in 3 cases, mild in 1 case, normal function in 1 case). Preoperative two-dimensional ultrasound showed three cases of DOMV, missed diagnosis in 2 cases (1 case prompted after the review). Real-time three-dimensional ultrasound prompted 4 cases of DOMV, 1 case did not perform real-time three-dimensional ultrasound before surgery, prompted after the review. Conclusion Compared with two-dimensional echocardiography, real-time three-dimensional echocardiography can display the spatial structure of mitral valve more comprehensively and stereoscopically, and improve the accuracy of diagnosis of DOMV. It can be an important complement to traditional two-dimensional echocardiography.