摘要
目的探讨彩色多普勒超声心动图对心肌致密化不全(NVM)的诊断价值,以预防致死性心律失常和栓塞。资料与方法彩色多普勒超声以左心室长轴、左心室短轴、心尖四腔等多切面扫查,重点观察近心尖1/3的心肌与心内膜。16例经心血管造影对照,11例行介入治疗,3例行手术治疗。结果 30例患者超声心动图检查心腔内异常粗大的肌小梁和其间深陷的隐窝。彩色多普勒显示隐窝内的低速血流与心腔内高速血流相通。25例为左心室型,2例为右心室型,3例为双心室型。2例因严重充血性心力衰竭而最终进行心脏移植。对受体心脏进行了病理解剖和组织学检查,受累心腔内显示有异常粗大的肌小梁和交错深陷的隐窝,从心底到心尖致密心肌逐渐变薄,心内膜为增厚的纤维组织,内层非致密心肌肌束粗大、细胞核异型,外层致密心肌肌束形态正常,细胞核大小均匀。结论彩色多普勒超声心动图是诊断左心室心肌致密化不全的首选方法,具有特征性意义。
Purpose By discussing the diagnostic value of Color Doppler Ultrasound of noncompaction of ventricular myocardium（NVM）,to prevent life-threatening arrhythmias and embolism.Materials and Methods Color Doppler Ultrasound adopts multiplanar scanning on long axis and short axis of left ventricle,apical four-chamber and so on,with an emphasis on observing myocardium and endocardium approach to one-third of apex of heart.16 cases were contrasted by angiocardiography,11 cases underwent interventional therapy and 3 cases underwent operation for combined congenital heart disease.Results Echocardiographic findings were shown in 30 cases of patients with prominent and excessive myocardial trabeculations and deep intratrabecular recesses in left ventricular.The Color Doppler flow imaging showed that blood in the muscular trabeculations tissues may circulate to chambers of the heart.Twenty-five cases of patients were of left ventricular,two cases were of right ventricular,three cases were of left and right.Two cases eventually underwent heart transplantation because of severe congestive heart failure.Gross and histological findings demonstrated prominent muscular trabeculations,with deep intratrabecular recesses into lesion heart.Serial section from the base of the ventricle toward the apex revealed gradually weaker myocardium.Noncompaction of ventricular myocardium showed a thin,compacted epicardial and an extremely thickened endocardium by fibrous tissue.Conclusions The Color Doppler echocardiography can be used as the first choice examination method for the diagnosis of noncompaction of ventricular myocardium.
出处
《中国医学影像学杂志》
CSCD
北大核心
2011年第3期197-200,共4页
Chinese Journal of Medical Imaging
关键词
心肌致密化不全
超声检查
多普勒
彩色
诊断
鉴别
Noncompaction of ventricular myocardium
Ultrasonography, Doppler,color
Diagnosis,differential
