经胸超声心动图评价婴幼儿卵圆窝处房水平分流及二维结构形态特征  

Transthoracic Echocardiographic Evaluation of Interatrial Shunt and Morphologic Structures of Oval Fossa in Infants

作　　者：高峻[1] 赵亚平[1] 张庆[1] 

机构地区：[1]武汉市儿童医院超声影像科,武汉市430016

出　　处：《中国超声医学杂志》2008年第8期721-724,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨婴幼儿卵圆窝处穿房隔分流束的形态特征及其二维超声解剖结构特征。方法回顾性分析了272例婴幼儿卵圆窝处分流束形态及其二维结构特征,剑下探查为观察房间隔结构及穿房隔分流束的重要声窗。结果婴幼儿卵圆窝处分流束及二维结构可表现为:(1)活瓣型165例,穿房隔分流束垂直于房间隔,卵圆孔瓣随两侧心房压力阶差不同呈活瓣样运动,产生不同方向的分流;(2)通道型81例,穿房隔分流束经卵圆孔瓣与继发隔之间形成的裂隙状通道(PFO通道)从一侧心房进入另一侧心房,形态呈"S"型或斜行穿隔;(3)多孔型5例,穿房隔分流束呈2束或多束细束状,卵圆孔处房间隔回声呈断续状;(4)房隔瘤型21例,卵圆窝处房间隔呈瘤样均向右房侧膨出,其中合并分流6例,瘤璧上可见破口。结论婴幼儿卵圆窝处房水平分流束形态对应不同解剖结构基础,超声心动图可为临床作出不同的处置提供重要依据。Objective To evluate the echocardiographic features of interatrial communication and anatomic oval fossa imaging in infants. Methods We retrospectively analysed the atrial shunt and anatomic imaging in the oval fossa area in 272 infants. Subcostal view was the most important section to observe the shunt and morphological features. Results The interatrial shunt and anatomical features in the oval fossa presented as the following four types： a. flapping valve type： the atrial level shunt was vertical to the atrial septum in 165 cases. Foramen ovale valve revealed a thin flapping valve, moved with cardiac motion causing different directions of shunts due to the pressure gradient of the two atriums, b. passage of septa foramen ovale （PFO） type, the shunt flowed through the tunnel between the oval fossa valve and septa secundum in 81 cases. The blood stream was like ＂S＂ shape or passed obliquely from one atrium to the another, c. multienestration type ; in 5 cases, two or more shunt singals were detected within the oval fossa. The structures of oval fossa was discontinued on 2D ultrsound, d. aneurism type： in 21 cases, the septum within the oval fossa was extended and protruded into the right atrium. 6 in 21 cases accompanied with atrial level shunt and with ruptured orifice on the aneurism wall. Conclusions The shunt within the oval fossa were related closely with the anatomic structures. Ultrasound could provide the informations for clinical to make different decisions.

关 键 词：经胸超声心动图 卵圆窝 房水平分流 

分 类 号：R445.1[医药卫生—影像医学与核医学]