Evaluation of Complex Congenital Heart Diseases with Real-Time Three-Dimensional Echocardiography

即時三度空間超音波在複雜性先天心臟病之應用

林竹川(Chu-Chuan Lin) ； 謝凱生(Kai-Sheng Hsie) ； 黃大誠( Ta-Cheng Huang) ； 翁根本( Ken-Peng Wong) ； 盧文憲( Wen-Hsien Lu) ； 簡光仁(Kaung-Jen Chien)

《Acta Cardiologica Sinica》 20卷1期 (2004/03) Pp. 21-30

摘要

Background. As a beating organ in the human body, the structure and motion of the heart can be depicted best with real-time 3-dimensional (RT-3D) image modality. Traditional M-mode and real-time two-dimensional (2D) echocardiography can be used for diagnosis of complex congenital heart defects, but with these modalities, the type of lesion and its complexity can only be appreciated indirectly, after composition of plane sections of different angles in mind. This study utilized the newly invented echocardiography platform for RT-3D scanning in selected patients with congenital heart diseases and evaluated its clinical applications in those patients.
Materials and Methods. Between February 2003 and April 2003, totally 18 patients of 4 different categories of diagnoses (4 cases with double-outlet right ventricle, 5 cases with tetralogy of Fallot, 4 cases with pulmonary atresia and intact ventricular sepum and 5 cases with single ventricle) were enrolled in this study. Scanning in these patients was performed with 2D scanner then the Philips SONOS 7500 system equipped with an Matrix probe. Their ages ranged from 10 days to 12 years, and the body weight ranged from 2.5 to 50 kilograms. Two modes of scanning were used in this study to evaluate the feasibility for diagnosis and analysis of the complex lesions in our patients. Comparison of clinical usefulness was also made with 2D echocardiography.
Results. The time spent for RT-3D scanning (11.4±1.4 min.) was significantly less than that for 2D platform (12.8±1.9 min.) ( p ＜ 0.01). Visceral situs was confirmed in 17 (94.4%) patients with the RT-3D platform and 16 (88.9%) patients with the 2D platform. Cardiac connections were analyzed segmentally, and 14 (77.8%) vs 13 (72.2%), 17 (94.4%) vs 16 (88.9), and 18 (100%) vs 18 (100%) patients were confirmed in their venoatrial, atrioventricular, and ventriculoarterial connections, respectively. Difference was found in confirmation of tricuspid and mitral valves in 13 (72.2%) and 10 (55.6%) with RT-3D and 2D platforms, respectively. One full-volume data set in each of 4 patient groups was used to analyze the 3D relationship of the complex lesions and their surrounding structures, and was demonstrated in this study.
Conclusion: The capability of the new RT-3D system for fast, accurate diagnosis of complex congenital heart lesions was demonstrated in this study. Meanwhile, with the RT-3D system, the examiner can delineate the complex intracardiac morphology and 3D relationships easily and intuitively. More clinical information can be derived from the new system, including that which is required for planning surgery. Improvement in image resolution and operation procedure has made this RT-3D scanning system ready for practically clinical application.

關鍵字

三度空間超音波 ； 先天性心臟病 ； 四度空間 ； 全影像

並列摘要

Background. As a beating organ in the human body, the structure and motion of the heart can be depicted best with real-time 3-dimensional (RT-3D) image modality. Traditional M-mode and real-time two-dimensional (2D) echocardiography can be used for diagnosis of complex congenital heart defects, but with these modalities, the type of lesion and its complexity can only be appreciated indirectly, after composition of plane sections of different angles in mind. This study utilized the newly invented echocardiography platform for RT-3D scanning in selected patients with congenital heart diseases and evaluated its clinical applications in those patients.
Materials and Methods. Between February 2003 and April 2003, totally 18 patients of 4 different categories of diagnoses (4 cases with double-outlet right ventricle, 5 cases with tetralogy of Fallot, 4 cases with pulmonary atresia and intact ventricular sepum and 5 cases with single ventricle) were enrolled in this study. Scanning in these patients was performed with 2D scanner then the Philips SONOS 7500 system equipped with an Matrix probe. Their ages ranged from 10 days to 12 years, and the body weight ranged from 2.5 to 50 kilograms. Two modes of scanning were used in this study to evaluate the feasibility for diagnosis and analysis of the complex lesions in our patients. Comparison of clinical usefulness was also made with 2D echocardiography.
Results. The time spent for RT-3D scanning (11.4±1.4 min.) was significantly less than that for 2D platform (12.8±1.9 min.) ( p ＜ 0.01). Visceral situs was confirmed in 17 (94.4%) patients with the RT-3D platform and 16 (88.9%) patients with the 2D platform. Cardiac connections were analyzed segmentally, and 14 (77.8%) vs 13 (72.2%), 17 (94.4%) vs 16 (88.9), and 18 (100%) vs 18 (100%) patients were confirmed in their venoatrial, atrioventricular, and ventriculoarterial connections, respectively. Difference was found in confirmation of tricuspid and mitral valves in 13 (72.2%) and 10 (55.6%) with RT-3D and 2D platforms, respectively. One full-volume data set in each of 4 patient groups was used to analyze the 3D relationship of the complex lesions and their surrounding structures, and was demonstrated in this study.
Conclusion: The capability of the new RT-3D system for fast, accurate diagnosis of complex congenital heart lesions was demonstrated in this study. Meanwhile, with the RT-3D system, the examiner can delineate the complex intracardiac morphology and 3D relationships easily and intuitively. More clinical information can be derived from the new system, including that which is required for planning surgery. Improvement in image resolution and operation procedure has made this RT-3D scanning system ready for practically clinical application.

並列關鍵字

Three-dimensional echocardiography ； Congenital heart disease ； Four-dimensional Full-volume