分散性主动脉瓣下狭窄彩色多普勒超声心动图图像特征及规律性研究  

Study on image characteristics and regularity of discrete subvalvular aortic stenosis in color Doppler echocardiography

作　　者：侯传举[1] 胡斌 邓东安[1] 崔建庄[3] 朱鲜阳[1] 穆莉[4] 

机构地区：[1]沈阳军区总医院心血管研究所,110016 [2]武警大连医院 [3]沈阳军区司令部门诊部 [4]武警辽宁总队沈阳一支队

出　　处：《中华超声影像学杂志》2002年第12期728-731,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨分散性主动脉瓣下狭窄 (DSAS)彩色多普勒超声心动图 (CDE)图像特征及规律性。方法　应用CDE检查 82例DSAS患者 ,寻找DSAS图像特征及规律性 ,2 6例经心血管造影对照 ,所有病例均经手术证实。结果　根据CDE图像特征对 78例DSAS做出正确诊断 ,诊断准确率 95 .1%。CDE图像特征及规律性明显 :①M型超声显示没有合并动脉导管未闭 (PDA)或室间隔缺损 (VSD)患者以室间隔、左室后壁对称增厚和升主动脉扩张为主 ,合并PDA或VSD者以左心房、左心室内径增大为主。②二维超声显示主动脉瓣下长短不一、距离不等的附加隔膜状回声 ,隔膜状回声越长狭窄越严重 ,附加隔膜状回声以室间隔单侧多见 ,于二尖瓣前叶上方双侧少见。③没有合并畸形患者彩色多普勒血流显像 (CDFI)只显示收缩期过主动脉瓣下五彩镶嵌射流束血流信号 ,合并PDA或VSD患者CDFI同时显示分流束血流信号 ,合并主动脉瓣关闭不全 (AI)或二尖瓣关闭不全 (MI)患者CDFI还显示过瓣膜反流束血流信号。④DSAS合并AI和PDA多见 ,合并VSD和MI次之 ,还有右心室流出道狭窄、右室双腔心和二尖瓣狭窄等少见合并畸形 ,孤立性DSAS少见。结论　DSAS的CDE图像特征及规律性明显 。Objective To probe into the imaging characteristics and regularity of discrete subvalvular aortic stenosis (DSAS) in color Doppler echocardiography (CDE).Methods Eighty-two patients with DSAS were examined by CDE to find out the characteristics and regularity of DSAS.Among them, 26 cases underwent angiocardiography for contrast.All cases were confirmed by operation.Results Seventy-eight cases were accurately diagnosed by CDE image with the diagnostic accuracy rate of 95.1% .The CDE characteristics and regularity were obvious as follows: ①On M-mode echocardiography,DSAS without patent ductus arteriosus (PDA) or ventricular septal defect (VSD) was characterized by symmetry thickened ventricular septum and posterior wall of left ventricle,dilated ascending aorta,while DSAS complicated with PDA or VSD showed enlarged left atrium and left ventricle.②On two-dimensional echocardiography,DSAS gave different length of septum-like echo beneath the aortic valve,which was more often seen on either side of ventricular septum than on both sides of anterior mitral valve leaflet.The longer the echo was,the more serious the stenosis was.③DSAS without complications only showed colorful discharge in a jet bunch flow signal while DSAS complicated with PDA or VSD also showed colorful shut bunch flow signal,and DSAS complicated with aortic valve insufficiency or mitral valve insufficiency still showed colorful regularity bunch flow signal across the valve.④DSAS was complicated more often with aortic valve insufficiency and PDA than with VSD and mitral valve insufficiency.DSAS complicated with right ventricular outflow stenosis,two chamber right ventricle and mitral valve stenosis was seldom seen,and isolated DSAS was rare.Conclusions The CDE imaging characteristics and regularity of DSAS are obvious,and CDE has specific diagnostic value for DSAS.

关 键 词：分散性主动脉瓣下狭窄 彩多普勒超声心动描记术 先天性心脏缺损 

分 类 号：R540.45[医药卫生—心血管疾病]