心腔内超声造影对左心室心肌致密化不全肌小梁的定量分析  

Quantitative Evaluation of Trabeculations in Noncompaction of Ventricular Myocardium Using Contrast Echocardiography

作　　者：朱烨[1] 陈明[1] 

机构地区：[1]同济大学附属东方医院心脏医学部,上海200120

出　　处：《中国医学影像学杂志》2014年第6期405-408,413,共5页Chinese Journal of Medical Imaging

基　　金：浦东新区卫生科技面上项目(PW2006A-6);浦东新区科技发展基金创新资金项目(PKJ2010-Y16)

摘　　要：目的采用左心室腔内超声造影(LVO)改善心内膜显影,测定左心室心肌致密化不全(NVM)患者LVO条件下的肌小梁影像学特征。资料与方法选择经常规超声心动图检查及LVO确诊的30例NVM患者,并选择30例健康成人作为对照组,在LVO条件下通过左心室多切面扫查,分析左心室心肌与心内膜的形态变化,应用二维超声测量肌小梁与隐窝的大小,定量分析左心室NVM心内结构的改变。结果 LVO可以更加清晰地观察到NVM患者非致密层心肌的范围,对比造影剂在小梁间隙和隐窝内充盈;NVM组肌小梁个数、长度、宽度均显著大于对照组(t=19.449、7.617、6.804,P<0.05)。左心室超声造影可以更加清晰地观察到非致密心肌的范围,造影剂在小梁间隙和隐窝内充盈,超声造影对致密心肌厚度的测量更为精确、客观。结论 LVO能够通过增强左心室腔的显影改善其心内膜边缘的清晰度,定量分析肌小梁的大小及形态,进一步诊断NVM。超声造影可以为肌小梁的测量提供更为精准、客观的影像。Purpose To determine the imaging characteristics of trabeculations in patients with noncompaction of ventricular myocardium（NVM） using echocardiography left ventricular opacification（LVO）.Materials and Methods Thirty patients with NVM diagnosed by both common echocardiography（CE） and LVO as well as 30 healthy controls were included in the study and examined with multi-view LVO.The morphological changes of the left ventricular myocardium and endocardium were analyzed.The size of trabeculations and intrabecular recesses were measured using two-dimensional ultrasound to quantitatively evaluate the structures in NVM.Results The extent of noncompact layers of myocardium was better visualized with LVO compared to CE.Contrast medium was filled between the trabeculations and within the intrabecular recesses.The number,length and width of the trabeculations were greater in the NVM group than the control group（t=19.449,7.617 and 6.804,P＆lt;0.05）.Conclusion Quantitative evaluation of regional endicardial morphology with LVO has the advantage of visualizing the structures and size of trabeculations in the patients with NVM to provide a precise and objective modality for diagnosing NVM.

关 键 词：心肌疾病 超声心动描记术 多普勒 彩色 心室功能 左 超声造影 微气泡 肌小梁 

分 类 号：R542.2[医药卫生—心血管疾病] R445.1[医药卫生—内科学]