心尖右心两腔观诊断小儿三尖瓣后瓣下移的方法探讨  

Diagnosis of the downward displacement of the posterior leaflet of tricuspid valve from apical right heart two chamber view by echocardiography

作　　者：蒋国平[1] 叶菁菁[1] 何瑾[1] 彭学慧[1] 赵镭[1] 何彧[1] 杨秀珍[1] 

机构地区：[1]浙江大学医学院附属儿童医院超声室,杭州310003

出　　处：《中华超声影像学杂志》2009年第4期305-307,共3页Chinese Journal of Ultrasonography

摘　　要：目的探讨超声心尖右心两腔观诊断小儿三尖瓣后瓣下移的方法。方法超声在心尖四腔观以隔瓣为中心，探头顺时针方向旋转至心尖右心两腔观，在旋转中动态显示三尖瓣隔瓣和后瓣的下移程度，观察三尖瓣后瓣的形态、活动和位置。彩色多普勒超声显示三尖瓣反流口位置。结果15例三尖瓣后瓣和隔瓣下移患儿，超声在心尖右心两腔观均可清晰显示三尖瓣后瓣下移的特征。除1例超声诊断三尖瓣隔瓣和后瓣下移而手术发现前瓣也有轻度下移外，超声与手术结果均相一致。15例患儿彩色多普勒均可显示三尖瓣反流口位置明显下移。结论心尖右心两腔观是诊断三尖瓣后瓣下移的理想切面。彩色多普勒显示三尖瓣反流口位置下移是超声诊断三尖瓣下移的重要特征。Objective To evaluate the value of echocardiography method for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve with apical right heart two chamber view （AP-RH-2CV）. Methods Rotating the probe clockwise from apical four chamber view（AP-4CV） to AP-RH-2CV at the septial and posterior leaflet of tricuspid valve, the shape, moving and position of the posterior leaflet of the tricuspid valve were observed by displaying the degree of downward displacement of the septial and posterior leaflet of tricuspid valve. The location of the orifice of tricuspid regurgitation was examined by color Doppler flow imaging（CDFI）. Results In 15 patients with Ebstein＇s anomaly from the AP-RH-2CV, the downward displacement of posterior leaflet of tricuspid valve was clearly observed at the AP-RH-2CV. These results of echocardiography were confirmed by surgery except one case missing out mild downward displacement of the anterior leaflet of tricuspid valve. Moreover, all 15 patients showed the obvious downward displacement of the location of the orifice of tricuspid regurgitation from AP-RH-2CV by CDFI. Conclusions The AP-RH-2CV is an ideal view in diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by echocardiography. The downward displacement of the location of the orifice of tricuspid regurgitation is a critical character for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by CDFI.

关 键 词：超声心动描记术 爱泼斯坦异常 临床分析 治疗方法 

分 类 号：R686[医药卫生—骨科学]