超声心动图和左室造影测量膜部室间隔缺损的相关研究  

comparative study on the measurement of ventricular septal defect by ultrasoundcardiogram and by left ventriculography

作　　者：李敬邦[1] 张玉顺[1] 李寰[1] 代正学[1] 李军[2] 张军[2] 

机构地区：[1]第四军医大学西京医院心脏内科,陕西西安710032 [2]第四军医大学西京医院超声诊断科,陕西西安710032

出　　处：《心脏杂志》2005年第2期192-194,共3页Chinese Heart Journal

摘　　要：目的对比分析超声心动图(UCG)和左室造影(LV)定量测量膜(周)部室间隔缺损(VSD)的相关性。方法全组患者106(男49,女57)例,年龄2～45(9.6±8.3)岁。UCG采用非标准左室长轴、大血管短轴及五腔切面;LV取左前斜位45°～60°加头位25°,测量VSD的大小,与主动脉瓣右冠瓣的距离。结果LV测量VSD大小显著大于左室长轴超声测量值(7.4±2.9mmvs5.2±2.3mm,P<0.05),而与大血管短轴及五腔心切面UCG测量值(7.0±2.9mm,7.0±3.2mm)无显著性差异(P>0.05)。大血管短轴与五腔心切面UCG测量VSD大小值之间无显著性差异(P>0.05),但显著大于左室长轴切面测值(P<0.05)。LV测量VSD距主动脉瓣距离显著大于左室长轴切面测值(3.4±1.0mmvs2.3±0.7mm,P<0.05),而与五腔心切面测值(3.0±1.0mm)无显著性差异(P>0.05)。五腔心切面所测室间隔缺损距主动脉瓣距离亦与LV测值显著相关(r=0.84,P<0.01)。UCG在大血管短轴切面所测室缺与三尖瓣的距离为3.3±1.3(1.5～7)mm。结论膜部VSD介入治疗时仍应以LV测量VSD的大小和位置为选择封堵器的“金标准”,UCG测量可以作为左室造影的重要补充;而VSD与三尖瓣的距离只能用UCG测量。AIM: To compare the measurement of ventricular septal defect (VSD) by ultrasoundcardiogram (UCG) and by left ventriculography (LV). METHODS: Total 106 VSD patients (49 male, 57 female), aged from 2 to 45 (average, 9.6±8.3), were investigated. By UCG, the size of VSD and the distance between VSD and the right coronary cusp was measured at non-standard parasternal left heart long axis view, parasternal aortic short axis view and apical 5-chamber view. By LV, the size of VSD and the distance between VSD and right coronary cusp were measured in left anterior oblique 45° ~60° +cranial 25°LV. RESULTS: The size of VSD measured in LV was significantly larger than that measured by parasternal left heart long axis view UCG (7.4±2.9 mm vs 5.2±2.3 mm, P<0.05), but no significant difference with that measured by parasternal aortic short axis view and apical 5-chamber view UCG (7.0±2.9 mm vs 7.0±3.2 mm, P>0.05). The size of VSD measured by parasternal aortic short axis view UCG had no significant difference with that measured at apical 5-chamber view UCG (P>0.05),but was significantly larger than that measured at parasternal left heart long axis view UCG (P<0.05).The distance of VSD to aortic valve measured by LV was significantly larger than that measured by parasternal left heart long axis view UCG (3.4±1.0 mm vs 2.3±0.7 mm, P<0.05),but no significant difference with that measured by apical 5-chamber view UCG (3.4±1.0 mm vs 3.0±1.0 mm, P> 0.05 ). The distance between VSD and aortic valve measured by apical 5-charmer view UCG was also significantly correlated with that measured by LV (r=0.84, P<0.01). The distance betweem VSD and tricuspid valve measured by parasternal aortic short axis view UCG was from 1.5 to 7 mm (averaged, 3.3±1.3mm). CONCLUSION: The size and location of VSD measured by LV should be 'golden standard' in selecting the occluders in transcatheter occlusion of VSD. UCG can be an important complementary to LV. The distance of VSD to tricuspid valve can only be measured by UCG.

关 键 词：室间隔缺损 超声心动描记术 心室造影 

分 类 号：R540.45[医药卫生—心血管疾病]