目的 :探讨实时三维超声心动图在房间隔缺损和室间隔缺损介入治疗中的应用价值。方法 :采用Philips公司Sonos75 0 0型超声心动仪 ,实时三维超声心动图技术 (real time 3 dimensionalechocar diography,RT 3DE) ,部分结合二维食管超声心动图 (transesophagealechocardiography ,TEE )及放射检查技术引导 12例先天性房间隔缺损 ,10例膜部室间隔缺损进行了经导管介入治疗手术。结果 :2 2例患者介入手术均获成功 ,术后无残余分流。RT 3DE对房、室间隔缺损的部位、大小、相对空间毗邻关系的判定均可获得比二维超声更丰富的数据信息 ,可靠性强。在引导介入手术中 ,无需全麻 ,操作简便 ,三维实时显像表现出良好的时间和空间分辨率 ,年龄限制少 ,一定程度上可减少放射应用剂量。术中实时测量三维距离 ,血流及多普勒技术的应用还受到技术制约。结论 :经胸RT 3DE作为无创心脏检查手段在引导房、室间隔缺损的介入手术中有肯定价值 ,并可望广泛应用于其他介入治疗 ,但其技术有一定的局限性仍需进一步改进 Objective: To investigate the value of real-time three-dimensional echocardiography in interventional treatment of atrial septal defect and ventricular septal defect. Methods: A total of 12 patients (12 eyes) were treated with Philips Sonos 7500 echocardiography and real-time 3-dimensional echocardiography (RT 3DE) with partial echocardiography (TEE) and radiological examination Congenital atrial septal defect, 10 cases of membranous ventricular septal defect by catheter interventional surgery. Results: Twenty-two patients were successful in interventional procedure without residual shunt. The RT 3DE can obtain richer data information than room two-dimensional ultrasound in the determination of the location of the ventricular and ventricular septal defect, the size and the relative spatial adjacent relationship, and has high reliability. In the guidance of interventional surgery, without general anesthesia, easy to operate, three-dimensional real-time imaging showed good time and spatial resolution, less age restrictions, to a certain extent, reduce the dose of radiation applications. Intraoperative real-time measurement of three-dimensional distance, blood flow and Doppler technology is also subject to technical constraints. Conclusion: Transient thoracic RT-3DE as a noninvasive cardiac examination has certain value in guiding the interventional surgery of ventricular septal defect and is expected to be widely used in other interventional treatments. However, its technical limitations still need further improvement