经胸和经食管超声心动图诊断卵圆孔未闭的对比研究  

Comparative Study on Diagnosis of Patent Foramen Ovale with Transthoracic and Transesophageal Echocardiography

作　　者：倪显达[1] 卢中秋[1] 徐湘挺[1] 管丽洁[1] 谷笑蓉[1] 胡元平[1] 

机构地区：[1]温州医学院第一附属医院超声影像科,浙江省温州市325000

出　　处：《中国超声医学杂志》2004年第4期279-282,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的　对比研究经胸超声心动图 TTE和经食管超声心动图 TEE对卵圆孔未闭 (patent foramen ovale,PFO)的诊断方法和诊断价值 ,及对卵圆孔未闭的临床意义。方法　运用经胸及经食管超声心动图检查 ,诊断卵圆孔未闭 2 4例 ,根据患者有无合并其他心脏疾患及合并的心脏疾患的血流动力学特点将患者分为卵圆孔未闭组及卵圆孔开放组。结果　经胸超声心动图通过 CDFI观察房水平的穿隔血流对卵圆孔未闭的诊断准确率为 5 8.3%。经食管超声心动图检查能对所有患者做出正确诊断。卵圆孔未闭组可见卵圆孔瓣上缘与继发隔之间裂缝 ,CDFI显示源于卵圆孔瓣与继发隔交界边缘处的穿隔血流 ;卵圆孔开放组可见卵圆孔瓣上缘与继发隔之间出现回声缺失 ,但卵圆孔瓣尚完整 ,CDFI于缺口处探及垂直于房间隔的穿隔分流束。结论　经食管超声心动图是目前卵圆孔未闭诊断金标准的首选方法。卵圆孔未闭可导致反常栓塞 ,应予以积极治疗。Objective:To comparatively study the values of transthoracic echocardiography (TTE)and transesophageal echocardiography(TEE)for diagnosis of patients with patent formamen ovale(PFO)and to study the clinical significance of PFO as well.Methods:Twenty-four patients with PFO,divided into PFO group and re-opened PFO group according to with and without other heart diseases and the hemodynamic features of combined heart diseases,were examined by TTE and TEE.Results:TEE achived a 58.3% diagnostic accuracy rate in patients with PFO by observing trans-diazoma blood stream at atrial level using CDFI,where as TEE could provide accurate diagnosis for all patients.In the PFO group,a crack was observed between the upper side of foramen ovale and the secondary diazoma;a trans-diazoma blood stream was shown from the junction border between foramen ovale and the secondary diazoma on CDFI;in re-opened PFO group,the echo between the upper side of foramen ovale and the secondary diazoma disappeared.while the foramen ovale became complete;however,on CDFI a bundle of blood stream perpendicular to the secomdary diazoma on the nick(the defect portion)could be seen.Conclusions:TEE is the first choice of golden standard for diagnosis of PFO at present.Patent foramen ovale will cause paradoxical embolism and should be treated as early as possible.

关 键 词：超声心动图 诊断 卵圆孔未闭 影像学诊断 诊断标准 

分 类 号：R445.1[医药卫生—影像医学与核医学]