Application value of real-time 3d echocardiography in diagnosis of valvular heart disease
经食管实时三维超声心动图在心脏瓣膜病诊断中的应用价值

摘要

目的 探讨经食管实时三维超声心动图（RT-3D-TEE）诊断心脏瓣膜病的可行性及临床应用价值。方法 选取2021年7月至2024年10月攀枝花市中心医院204例疑似心脏瓣膜病患者，分别采用RT-3D-TEE与TTE检测瓣膜病变部位、类型、程度，测量瓣环直径及开口面积，以手术结果为金标准，对比两种技术的诊断效能。结果 RT-3D-TEE在瓣膜病变类型、程度、瓣环径测量上的准确性显著高于TTE（P<0.05），且与手术诊断结果无统计学差异（P>0.05）。其中，RT-3D-TEE对二尖瓣、主动脉瓣、三尖瓣病变的诊断准确率分别为94.8%、93.4%、94%，均高于TTE的80.9%、84.9%、72%；其测量的主动脉瓣、二尖瓣、三尖瓣瓣环径分别为23.13±1.85mm、35.99±1.37mm、35.82±1.14mm，与术中值（23.17±1.77mm、36.04±1.41mm、35.86±1.01mm）无统计学差异，而TTE测量的瓣环径显著小于术中值（P<0.05）。结论 RT-3D-TEE诊断心脏瓣膜病准确性高，能为临床精准诊断与治疗方案制定提供可靠依据，具有重要临床应用价值。

Abstract

Objective To investigate the feasibility and clinical application value of real-time three-dimensional echocardiography (RT-3D-TEE) in diagnosing cardiac valvular disease.
Methods A total of 204 suspected cardiac valve disease patients at Panzhihua Central Hospital from July 2021 to October 2024 were selected. Both RT-3D-TEE and transient Tissue Echocardiography (TTE) were used to detect the location, type, and severity of valvular lesions, while measuring annular diameter and opening area. Surgical outcomes were used as the gold standard to compare diagnostic efficacy between the two techniques.
Results RT-3D-TEE demonstrated significantly higher accuracy than TTE in identifying valve lesion types, severity, and annular diameter measurements (P<0.05), with no statistically significant difference compared to surgical diagnoses (P>0.05). Specifically, RT-3D-TEE achieved 94.8%,93.4%, and 94% diagnostic accuracy for mitral, aortic, and tricuspid valve lesions respectively, surpassing TTE's 80.9%,84.9%, and 72% accuracy. The measured annular diameters for these valves were 23.13±1.85mm, 35.99±1.37mm, 35.82±1.14mm, showing no statistically significant difference from intraoperative values (23.17±1.77mm, 36.04±1.41mm, 35.86±1.01mm), while TTE measurements were significantly smaller than intraoperative values (P<0.05).
Conclusion   RT-3D-TEE provides high diagnostic accuracy for cardiac valvular disease, offering reliable evidence for precise clinical diagnosis and treatment planning, thus demonstrating significant clinical value.