Objective To explore the feasibility and clinical significance of real-time three-dimensional echocardiography (RT-3DE) in assessing atrial septal defect.to investigate the reliability of RT-3DE findings compared with operation.to record dynamic changes of atrial septal defect (ASD) during a cardiac cycle and analyze the risk factors which influence ASD.Methods From June 2010 to Jan 2012,32 patients with ASD undergoing surgical treatment at our institution were enrolled in the study.RT-3DE was performed with Philips iE33 and offline analysis with QLab work-station.3D data were compared with measurements and descriptions by 2-dimentional echocardiography and surgical findings.Results Acquisition of RT-3DE data was feasible in 93％ of patients.The sizes obtained from RT-3DE showed better correction with surgical findings than measurement by 2D echocardiography (r =0.96 vs r =0.92).The ASD area showed dynamic changes during the cardiac cycle with an end-systolic maximum and end-diastolic minimum.There was no correlation between the relative change and ASD size or heart rate.Conclusion RT-3DE provides more spacial information in congenital heart disease,and offers accurate assessment of septal defect location,size,numbers,and surrounding structures.With a short learning curve,RT-3DE is easily applicable during daily clinical practice.%目的 探讨实时三维超声心动图(RT-3DE)技术评价房间隔缺损(ASD)的可行性和临床价值；评价RT-3DE测值和手术的相关性；记录房间隔缺损在心动周期中的动态变化及影响因素.方法 收集2010年6月至2012年1月我院心脏外科行外科手术治疗的房间隔缺损患者32例,应用Philips iE33行RT-3DE成像,Qlab工作站载机和脱机分析.分别将二维、三维测值与手术测值行相关分析.结果 93％的患者可以获得RT-3DE数据.RT-3DE测得的缺损大小与手术的相关性优于二维(r分别为0.97和0.92,P＜0.05).ASD在心动周期中呈现动态变化,收缩末期最大,舒张末期最小.结论 RT-3DE可为先天性心脏病提供更多的空间信息,进行缺损部位、大小、数目、毗邻结构的确切评价.
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