经胸和多平面经食管超声心动图诊断三尖瓣下移畸形  

Diagnosis of Ebstein’s anomaly with transthoracic echocardiography and multiplane transesophageal echocardiography

作　　者：李冬蓓[1] 黄云洲[1] 任书堂[1] 刘晓程[1] 孔祥荣[1] 林云佳[1] 

机构地区：[1]天津泰达国际心血管病医院,天津300457

出　　处：《中国临床医学影像杂志》2009年第2期97-99,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨经胸超声心动图(TTE)和多平面经食管超声心动图(MTEE)在三尖瓣下移畸形诊断中的应用价值及对外科手术的指导意义。方法:回顾性分析13例经手术证实的三尖瓣下移畸形患者术前TTE和其中5例术中MTEE的表现,并与手术结果进行对照。结果:13例TTE检查中单纯隔叶下移1例,三尖瓣隔、后叶均下移12例;其中5例术中MTEE检查三尖瓣重度下移并功能右室发育小,室壁薄2例,三尖瓣叶严重畸形3例。13例患者根据不同程度的畸形分别行瓣膜成形术6例,瓣膜置换术5例,双向Glenn术2例。结论:TTE可诊断三尖瓣下移畸形,MTEE可更准确地评价瓣膜及右心室的功能,二者结合可更好地指导外科医生对不同程度的畸形选择不同的手术方式,提高手术成功率。Objective： To explore the application value and the guidance for surgical operation of transthoracic echoeardiography（TTE） and muhiplane transesophageal echocardiography（MTEE） in the diagnosis of Ebstein＇s anomaly. Methods： Preoperative TTE features in 13 cases of Ebstein＇s anomaly and intraoperative MTEE features in 5 of them were analyzed retrospectively, comparison to the operation results was earried out. Results： Among the 13 cases, 1 case was diagnosed as Ebstein＇s anomaly with solitary displacement of septal leaflet, 12 cases with displacement of septal and posterior leaflets by TTE. Among the 5 cases, 2 cases were diagnosed as severe displacement of the leaflets with functional right ventricle hypoplasia and thinning of the wall, 3 cases with severe abnormalities of the leaflets by MTEE. Among the 13 cases with different degree of abnormalities, 6 cases received valvuloplasty, 5 cases received valvular replacement procedure, 2 cases received bidirectional Glenn shunt procedure. Conclusions： TTE can diagnose Ebstein＇s anomaly, MTEE can evaluate the function of tricuspid leaflets and right ventricle more accurate, if the two examination methods were combined together, they can help surgeon to choose the better operation methods for treating various degree of anomalies and improve the success rate.

关 键 词：心脏病 三尖瓣 超声心动描记术 

分 类 号：R542.53[医药卫生—心血管疾病] R540.45[医药卫生—内科学]