Vai trò của siêu âm tim 3d

3D ECHOCARDIOGRAPHY
IN DIAGNOSIS OF
CARDIOVASCULAR DISEASE
Nguyen Tuan Vu MD PhD
MEDIC HCMC
PNT-U
MAINZ University


Introduction
3D Echocardiography was introduced after the
year 2000.
Fully sampled matrix array transducers .
Live 3D, 3D Zoom and Full Volume modes.
Used to select and guide the most appropriate
intervention during BMV, MitralClip, TAVI…
3D Echocardiography applied in diagnosis of
cardiovascular disease at MEDIC HCMC since
January 2012.


Patients & Methods
-Pts with 3D TTE and 3D TEE at Medic HCM
since January 2012
-Instrument:
Phillip ie 33
3D TTE Probe 2 MHz and 3D TEE 5MHz Probe
-Techniques: 2D X plane, Live 3D, 3D Zoom,
Full Volume
- Case series report study
- Compare the diagnosis before and after

intervention or operation.


3 D Echocardiography
Fully sampled MatrixArray Transducer
3000 Piezoelectric
Elements
TTE 2-4MHz
TEE 5-7MHz


Data Acquisition
Live 3 D : real time 3 D
mode, narrow sector
Full volume: gated
acquisition
Zoom 3D: focused wide
sector


Results

44%

20%
MR, chordea rupture
Bicuspid Aorta
Coronary Fistula
Mechanical Valve
Endocarditis

Myxoma
Aortic Dissection


Philips IE 33


Mitral Stenosis
Advantages of 3D Echocardiography
Visualize the entire MV and associated structures
More reliable Planimetry of the mitral orifice by using
MPR.
Detection of complicated commissural fusion.
The 3 D dataset may be oriented to view the MV from
the surgeon view.
Leaflet mobility particularly well analyzed in the 3D Zoom
mode.
More sensible in detecting LA and LAA Thrombi.
Monitor and guide the catheter during BMV.


Mitral Regurgitation

Anatomical detail of MV
Clip 1


Echocardiographic Anatomy
Mitral leaflets

TEE and surgeon view

Normal MV fr LA view


MS: 3D TTE
LAX View

SAX View


MS: 3D TTE
Apical 4 C View

Live 3 D with color


MS, LAA Thrombus


Mitral Stenosis 3D Zoom

Clip 3 D Zoom


LA Thrombus

I crop LA Thrombus

LAA Thrombus

Normal LAA

LAA Thrombus


Guide the catheter during BMV

Fluoroscopy

Live 3D Echocardiography


Mitral Regurgitation


Mitral Regurgitation


Mitral Regurgitation
3D Zoom

3D Live with color


Mitral Regurgitation


Mitral Regurgitation: 2 Jets

Graduation of MR: PISA
Method


Mitral Regurgitation
3D ECHOCARDIOGRAPHY
Mechanism of MR.
Graduation: Vena Contracta, MR Volume (
PISA 2D, 3D ).
Detection of multiple Jets.
Location of lesion: segment I,II,III
Monitoring MitralClip procedure
Criteria for MitralClip : functional MR,
segment II, PML <10mm .


Guiding septal puncture and
MitralClip