多平面经食管超声心动图在鉴别左心耳内血栓与梳状肌的作用  

Usefulness of Multiplane Transesophageal Echocardiography in Differentiating Left Atrial Appendage Thrombus From Pectinate Muscles

作　　者：杨宗奇[1] 沈卫峰[1] 张绍昌[2] 施仲伟[1] 胡厚达[1] 陶巨蔚[2] 

机构地区：[1]上海第二医科大学附属瑞金医院心内科,上海市200025 [2]上海胸科医院

出　　处：《中国循环杂志》1999年第1期39-40,共2页Chinese Circulation Journal

摘　　要：目的；了解多平面经食管超声心动图（TEE）在鉴别左心耳内血栓与梳状肌的作用。方法：采用多平面TEE观察54例风湿性心脏病二尖瓣狭窄患者左心耳结构。结果：54例患者中，30例在0～90°扫描切面左心耳尖部或侧壁出现直径0．30～0．78cm大小回声，类似血栓形成，但当扫描切面转至110～135°时，左心耳底部可见2～4个平行排列、清晰的点状或条索状回声，为梳状肌，其中12例为手术证实；24例在0～90°C以及110～135°时左心耳和（或）左心房体部可见直径1．0～3．4cm大小边缘清楚、致密的回声光团，为血栓形成，其中18例为手术证实。结论：多平面TEE能清晰观察左心耳内发达的梳状肌，并能与血栓作出可靠的鉴别诊断。Objective:To understand the usefulness of multiplane transesophageal echocardiography(TEE) in differentiating left atrial appendage(LAA) thrombus from pectinate muscles.Metheds:Fifty-four patients with rheumatic mitral stenosis were performed multiplane TEE to observe the structre ofLAA.Results:In 30 among the 54 patients,with 0 degree to 90 degree imaging planes, mass(0. 30-0. 78 cm in diameter)present in the lateral wall or apex of LAA that may mimic thromi. By rotating transducer to 110 degree to 135 degree imagingplanes,2-4 distinct pectinate muscles were identified,and no thrombus was seen,which were confirmed in operation in 12patients. In another 24 patients,thrombi(1. 0-3.4cm in diameter)in the LAA and/or left atrial body were detected both at0 degree to 90 degree imaging planes and 110 degree to 135 degree imaging planes,these were in agreement with findingsduring operation in 18 patients.Conclusion: Multiplane TEE could provide a unique view for us to clearly visulize the pectinate muscles and thus to differentiate it from thrombus.

关 键 词：左心耳内血栓 梳状肌 超声心动图 TEE 鉴别诊断 

分 类 号：R540.45[医药卫生—心血管疾病] R541.04[医药卫生—内科学]