Development of real-time three-dimensional ultrasound system without reconstruction and its clinical application in cardiac surgery.

使用连续的2-D回波图像的心脏的三维（3-D）重建与若干问题相关联。从数据采集到三维显示的处理通常是耗时的。这些问题限制了三维超声心动图在心血管外科领域的临床应用。本研究的目的是开发一种新的三维超声系统，空间描绘心脏内结构的边界在真实的时间和评价其在主要心脏瓣膜疾病的临床可行性。本研究新开发的实时三维超声系统可以从相控阵换能器（3.5MHz）的机械扫描中获取体积数据并显示体积绘制图像，而无需存储图像数据和重建过程。该系统不仅允许实时数据采集，但三维显示。1998年首次对左心室、二尖瓣等心内结构进行了三维重建， ...更多信息 20例患者中有16例（pts.）经胸入路应用新系统。在该系列的4例患者中，超声束的穿透受到胸壁的干扰，导致探头尺寸过大导致成像不佳。在第二个研究年（1999年），三维成像的帧速率增加到8 f/sec使用数字并行处理。该装置提供了经胸方法的实时三维成像的改善的图像质量。24分。(10正常心脏14例，二尖瓣病变14例。10例正常心脏左心室腔及二尖瓣结构均清晰可见。在14名二尖瓣疾病患者中，11名患者的二尖瓣病变实时成像正确。在该系列中的3例中，超声穿透不足导致3-D成像不良。总之，新开发的无重建过程的实时3-D超声系统在临床上可用于真实的实时成像二尖瓣、瓣膜和左心室腔的空间解剖结构。随着技术的进一步改进，这种新的系统，用于直接心外膜的方法，有潜在的有用性，在提高修复程序的准确性，在心脏外科手术。少

Three-dimensional (3-D) reconstruction of the heart using consecutive 2-D echo images is associated with several problems. The processing from data acquisition to 3-D display is generally time consuming. These problems limits clinical use of 3-D Echocardiography in cardiovascular surgical fields. The purpose of this research was to develop a new 3-D ultrasound system which delineates spatially the boundaries of intracardiac structure in real time and to evaluate its clinical feasibility in mainly valvular heart diseases. The newly developed real-time 3-D ultrasound system by the present research can acquire volumetric data from mechanical scanning of the phased array transducer (3.5MHz) and display the volume rendered images without storage of the image data and reconstruction process. This system allows not only real-time data acquisition but 3-D display. In the first research year (1998), 3-D images of the intracardiac structure intcluding left ventricle and mitral valve were clearly … More and correctly obtained in 16 of 20 patients (pts.) using the new system by transthoracic approach. In 4 pts.of this series, the penetration of ultrasound beam was disturbed by the chest wall resulting in suboptimal imaging caused by the large size of a probe. In the 2nd research year (1999), the frame rate of 3-D imaging was increased up to 8 f/sec using digital parallel processing. This device offered the improved image quality of real-time 3-D imaging by transthoracic approach. 24 pts. (10 ; normal heart, 14 ; mitral heart disease) were examined using the improved system by transthoracic approach. In all 10 normal hearts, the cavity of left ventricle and mitral valve structure was clearly visualized. In 11 of 14 pts.with mitral disease, pathologies of mitral valve were imaged correctly in real-time. In 3ts.of this series, penetration of ultrasound was insufficient causing poor 3-D imaging. In conclusion, the newly developed real-time 3-D ultrasound system without reconstruction process was shown to be clinically feasible for imaging of spatial anatomy of the mitral, valve and the cavity of the left ventricle in real time. With further technological improvement, this new system, used by direct epicardial approach, has the potential usefulness in increasing the accuracy of repairing procedures in cardiac surgery. Less