摘要: |
病理性的三尖瓣反流会引起患者病死率的升高。临床上,超声心动图发挥着重要的作用。在瓣膜形态的评估上,实时三维超声心动图在弥补了二维超声心动图成像不足的基础上,能完整地显示三尖瓣及其周围的结构,帮助人们更好地诊断三尖瓣返流。在定量分析三尖瓣反流上,二维超声心动图的彩色多普勒技术主要在缩流颈宽度、近端等速表面积的半径、使用近段等速表面积量化的有效瓣口反流面积和反流量以及肝静脉血流图等指标上发挥作用。由于技术的限制,这些指标都具有各自的不足。实时三维超声心动图的彩色多普勒技术衍生出缩流颈面积这一新指标,在诊断重度三尖瓣反流以及确定其截断值方面更有价值。三尖瓣的手术中,实时三维超声心动图也占据重要的地位,尤其是在经导管的三尖瓣手术中,能全程指导定位并进行评估。尽管仍有不足,超声心动图在三尖瓣反流的诊断和治疗中仍有较大的发展空间。 |
关键词: 三尖瓣关闭不全 定量 实时三维超声心动图 缩流颈面积 |
DOI:10.12025/j.issn.1008-6358.2021.20200100 |
分类号:R542.5+3 |
基金项目:国家自然科学基金面上项目81771873,上海市医学引导类项目17411962400 |
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Application of real-time three-dimensional echocardiography in patients with tricuspid regurgitation |
chen beiqi, kong dehong, dong lili
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Departmeng of Echocardiography,Zhongshan Hospital of Fudan University
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Abstract: |
Pathological tricuspid regurgitation (TR) can cause an increase in the mortality of patients. Clinically, real-time echocardiography plays an important role. Three-dimensional echocardiography makes up for the shortcomings of two-dimensional echocardiography and can fully display the tricuspid valve and its surrounding structures, helping doctors to better diagnose TR in the evaluation of valve morphology. The color Doppler technology of two-dimensional echocardiography can help doctors to analyze TR quantitatively. The main indicators include the vena contracta width, the radius of proximal isovelocity surface area (PISA), the effective regurgitant orifice area and the regurgitant volume using PISA and hepatic vein flow. However, due to technical limitations, these indicators have their own shortcomings. The new index of vena conracta area derived from three-dimensional echocardiographic color Doppler technology is more valuable in diagnosing severe TR and determining its cutoff value. Echocardiography also plays an important role in tricuspid valve surgery, especially in transcatheter tricuspid surgery, which can guide the positioning and evaluation throughout. Despite some shortcomings, echocardiography still has great prospects of development in the diagnosis and treatment of TR. |
Key words: Tricuspid regurgitation Quantify Real-time three-dimensional echocardiography Vena contracta area |