3D-TEE对不同表型二尖瓣脱垂患者的二尖瓣环分离形态及功能的定量研究  

Quantitative Study of Mitral Annular Disjunction Morphology and Function in Patients with Different Phenotypes of Mitral Valve Prolapse by Three-Dimensional Transesophageal Echocardiography

作　　者：崔抒宇 梁彗莉 姚沐欣 杨军[1] 马春燕[1] 陈昕[1] Cui Shuyu;Liang Huili;Yao Muxin;Yang Jun;Ma Chunyan;Chen Xin(Department of Cardiovascular Ultrasound,Clinical Medical Research Center of Imaging in Liaoning Province,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院心血管超声科、辽宁省影像医学临床医学研究中心,沈阳市110001

出　　处：《中国超声医学杂志》2025年第1期26-30,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用3D-TEE定量评估二尖瓣环分离(MAD)在不同表型二尖瓣脱垂(MVP)患者中的形态及其对二尖瓣结构及功能的影响。方法回顾性纳入TEE诊断为中、重度二尖瓣反流的MVP患者80例,根据有无MAD分为MAD(+)组39例及MAD(-)组41例,MAD(+)组分为巴洛氏病(BD)组25例和弹性纤维缺乏(FED)组14例,50例健康体检者为对照组,对二尖瓣图像进行定量分析。结果MAD(+)组收缩末期瓣环直径、周长、面积大于MAD(-)组及对照组,高度及瓣高联合比减小(P<0.05);BD组MAD三维分布范围大于FED组,其瓣环结构、功能及瓣叶形态改变较FED组显著(P<0.05)。结论MAD引起反常的瓣环动力学,不同表型MVP的MAD三维形态不同,对瓣环、瓣叶的影响亦不同。Objective To quantitatively evaluate the morphology of mitral annular disjunction(MAD)in different phenotypes of mitral valve prolapse(MVP)and its influence on mitral valve structure and function by three-dimensional transesophageal echocardiography.Methods Eighty MVP patients diagnosed as moderate or severe mitral regurgitation by transesophageal echocardiography were retrospectively enrolled.According to with or without MAD,the case group was divided into MAD(+)group(39 cases)and MAD(-)group(41 cases),and the MAD(+)group including Barlow's disease(BD)group(25 cases)and elastic fiber deficiency(FED)group(14 cases).50 healthy people were enrolled as control group.Quantitative analysis was performed in mitral valve images.Results In MAD(+)group,the diameter,circumference and area of the valve annulus at the end of systole were larger than those in MAD(-)group and control group,and the height and the joint ratio of valve height decreased(P<0.05).The three-dimensional distribution of MAD in BD group was larger than that in FED group,and the changes of valve ring structure and valve leaf morphology in BD group were more significant than those in FED group(P<0.05).Conclusions MAD causes abnormal valve annulus dynamics.Different phenotypes of MVP have different three-dimensional morphology of MAD,and have different effects on valve annulus and leaflets.

关 键 词：经食管超声心动图 三维 二尖瓣环分离 二尖瓣脱垂 二尖瓣环 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.51[医药卫生—诊断学]