老年人左室附壁血栓彩色多普勒超声心动图特征和规律性研究  

Study on characteristics and regularity of left ventricular thrombus in color Doppler echocardiography

作　　者：沈南 高健 侯传举[2] 

机构地区：[1]辽宁省盘锦市中心医院超声科,辽宁盘锦124010 [2]中国人民解放军沈阳军区总医院,辽宁沈阳110840

出　　处：《医学影像学杂志》2017年第10期1890-1893,共4页Journal of Medical Imaging

摘　　要：目的探寻老年人左室附壁血栓(LVT)彩色多普勒超声心动图(CDE)特征和规律性。方法应用CDE检查30例老年人LVT,寻找老年人LVT的CDE特征及规律性。结果根据CDE特征对30例老年人LVT全部做出正确诊断,对所有合并畸形全部做出正确诊断。老年人LVT的CDE特征和规律性明显:1)M型超声心动图显示左心房、左心室内径不同程度增大,在1区室间隔与左心室后壁运动幅度降低,在2区室间隔与左心室后壁运动幅度相对增强;2)二维超声心动图显示左心室下部至心尖部心肌变薄,向外膨出,呈矛盾运动,在左心室近心尖部均显示一大小不等光团回声,最小0.8cm×1.0cm,最大1.8cm×2.2cm,光团回声与左心室壁关系密切,不随心动周期往返摆动;3)彩色多普勒血流显像显示收缩期过二尖瓣反流束血流信号;4)采用simpson法估测左心室射血分数均有不同程度降低,临床采取治疗措施后,CDE跟踪检查随访左心室射血分数逐渐提高;5)所有老年人LVT均为单发,并与左心室室壁瘤伴行,临床采取治疗措施后,CDE跟踪检查随访该光团回声逐渐缩小;6)老年人LVT患者男性明显多于女性。结论老年人LVT的CDE特征和规律性明显,CDE对老年人LVT有特异性诊断价值。Objective To probe into the features and patterns of color Doppler echocardio-graphy（ CDE） of elderly with left ventricular thrombus（ LVT）. Methods We adopted CDE to examine 30 LVT cases to discover the features and patterns of LVT. Results All the 30 LVT cases and all the accompanied malformations are correctly diagnosed according to the CDE features. The features and patterns of CDE are evident： 1） M-mode echocardiography shows that the inner diameters of the left atrium and the left ventricle are larger in varying degrees. In zone 1,the motion range of ventricular septum and left ventricular posterior wall is decreased,while in zone 2,the motion range of ventricular septum and left ventricular posterior wall is relatively increased; 2） The two-dimensional echocardiography shows that the myocardium from bottom of LVT to the ventricular apex becomes thin and bulges outward,in paradoxical movement; an echo shadow in different sizes can be seen near the ventricular apex of the left ventricle,out of which the smallest is 0. 8 cm × 1. 0 cm and the largest 1. 8 cm × 2. 2 cm. The echo shadow is closely related to the left ventricular wall and does not oscillate with the cardiac cycle; 3） Color Doppler flow image shows mitral regurgitation flow signal during systole; 4） All the left ventricular ejection fractions decrease to some extent estimated by Simpson＇s rule. After clinical treatments,the LVTs gradually increase according to CDE follow-up examination; 5） All the of elderly with LVTs are solitary and adjacent to left ventricular aneurysm,after clinical treatment,the echo shadows gradually shrink according to CDE followup examination; 6） and Males of elderly with LVT patients are significantly more than female patients. Conclusion The CDE of elderly with LVT shows evident features and patterns and it has specific diagnostic value for LVT.

关 键 词：左室血栓 老年人 彩色多普勒超声心动图 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.3[医药卫生—诊断学]