致心律失常性右心室心肌病的造影诊断  

Angiographic diagnosis of arrhythmogenic right ventricular cardiomyopathy

作　　者：张群[1] 杨向太[1] 唐向周[1] 方咸宏[1] 成佛金[1] 王绍荣[1] 

机构地区：[1]广东省人民医院广东省医学科学院广东省心血管病研究所心导管室,广州510080

出　　处：《岭南心血管病杂志》2009年第4期295-298,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的评价心血管造影术(angiocardiography,ACG)对致心律失常性右心室心肌病(arrhythmogenicright ventricular cardiomyopathy,ARVC)的诊断价值和限度。方法对11例临床确诊ARVC的患者行左心室、右心室造影,观察其形态及运动功能(特别是漏斗流出道、心尖小梁部以及下壁)。结果11例均行右心室造影,形态上表现为漏斗流出道扩张,其中7例为局限性扩张,3例为局限性扩张并囊袋状突出,1例为局限性扩张并叠盘状影;心尖小梁部8例叠盘状影,2例囊袋状突出,1例叠盘状影并囊袋状突出;下壁9例囊袋状突出,1例叠盘状影,1例囊袋状突出并叠盘状影。在运动功能异常方面,运动减弱最明显,分别见于漏斗流出道8/11,心尖小梁部10/11,下壁10/11;其次为无运动,分别发生在漏斗流出道2/11,心尖小梁部1/11,下壁1/11。1例还另行左心室造影,表现为:小梁粗大,心尖囊袋状突起,切迹,室间隔光滑。结论右心室造影,征象明确,只要抓住发育不良三角形态及功能变化,就能作出正确诊断。ACG是ARVC诊断和鉴别诊断的重要依据。Objectives To evaluate the diagnostic value and limitation of angiocardiography (ACG) in arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods ACG was performed in 11 patients who had been considered as ARVC. All patients underwent angiographic examination of the right and left ventricule. Morphological and funtional alterations were observed. Results Right ventricular angiographic morphological signs of 11 patients were: expand (7) , expand and multiple localized akinetic bulges ( 3) , expand and piled' assiettes ( 1) in the outflow tract, piled' assiettes (8) , multiple localized akinetic bulges (2) , piled' assiettes and multiple localized akinetic bulges ( 1) in the trabecular area; multiple localized akinetic bulges ( 9) , piled' assiettes ( 1) , piled' assiettes and multiple localized akinetic bulges (1) on the inferior wall. Funtional alterations were localized dyskinesia: 8 in the outflow tract, 10 in the trabecular area, 10 on the inferior wall; localized akinesia: 2 in the outflow tract, 1 in the trabecular area, 1 on the inferior wall. Left ventricular angiographic signs of 1 patient were: hypertrophic muscular trabeculae, localized akinetic bulges and impression in the apex of the left ventricular and velvet ventrcular septation. Conclusions Right ventricular angiography is the first choice for examing ARVC. The outflow tract, trabecular area and inferior wall of right ventricle should be sufficiently showed. Diagnosis and differential diagnosis of ARVC are depended mainly on ACG.

关 键 词：心律失常性右心室发育不良 心血管造影术 诊断 

分 类 号：R542.2[医药卫生—心血管疾病]