日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Pediatric Cardiology and Cardiac Surgery 32(2): 87-94 (2016)
doi:10.9794/jspccs.32.87

ReviewReview

3D心エコー:どうやって使えば手術に役立てられるか? 解剖学的評価を中心にHow to Use 3-dimensional (3D) Echocardiography for the Anatomical Assessment of Surgical Repair of Congenital Heart Diseases

長野県立こども病院循環器小児科Nagano Children’s Hospital Department of Pediatric Cardiology ◇ Nagano, Japan

発行日:2016年3月1日Published: March 1, 2016
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超音波装置,探触子および解析ソフトウエアー等における著しい技術の進歩により,3D心エコー法により得られた画像のクオリティは飛躍的に向上した.現在では,先天性心疾患に対する診断や治療にも有用なツールであるといっても過言ではない.実臨床で有用な活用法の1つは,複雑な心内形態を3D表示し,それに基づいて修復術のプランニングやガイドを行うことである.例えば,両大血管右室起始症における心室中隔欠損を用いた心内ルート作成,複雑な房室弁閉鎖不全の形成,肺静脈還流の異常や狭窄の修復などが挙げられる.これら疾患に対して,収集した3Dデータをクロッピングという再構築を行い,複雑な心内構造を外科医からの視点(Surgeon’s view)で観察する.これにより,病態と手術法について,外科医と循環器医でより深いdiscussionを行うことが可能となる.本稿では,心内の3次元的な解剖学形態評価を基にした外科的修復術のガイドの方法について小児の心エコー初心者にも理解できるように概説したい.

Recently, revolutionary advancements regarding the ultrasonic apparatus, three-dimensional (3D) echo probe, and PC analysis workstations have been achieved, and these have drastically improved the quality of 3D imaging. Additionally, 3D echocardiography has become one of the most useful diagnostic and therapeutic tools for congenital heart disease. One of the most effective applications is to provide critical information of complicated intracardiac 3D structures of the heart for planning cardiac surgery. This includes the creation of an intracardiac route via the ventricular septal defect in patients with a double outlet right ventricle, valvuloplasty for complicated atrioventricular valve regurgitation, or the repair of intracardiac stenotic lesions (e.g., pulmonary venous obstruction). The digitally acquired 3D volume data is reconstructed by “cropping” and then complex intracardiac structures can be observed from the surgeon’s standing point (i.e., surgeon’s viewpoint). Therefore, this technology can serve as the basis of profound communication between cardiologists and cardiac surgeons. In this chapter, I would like to address how to use 3D echocardiography as a guide for surgical repair in actual clinical practice and explain the process in detail for the pediatric cardiology trainees to understand with ease.

Key words: congenital heart disease; 3-dimensional echocardiography; transpericardial 3D echocardiography

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This page was last modified on 2016-04-12T11:50:35.147+09:00


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