摘要
目的:探寻急性心肌梗死并发室间隔穿孔(VSR)彩色多普勒超声心动图(CDE)特征。方法:应用CDE检查30例急性心肌梗死并发VSR。26例行心血管造影检查,19例行VSR封堵术介入治疗,3例行冠状动脉搭桥和VSR修复术治疗。结果:根据CDE特征对30例中老年急性心肌梗死并发VSR全部做出正确诊断。急性心肌梗死并发VSR的CDE特征明显:①二维超声心动图间接特征显示左心房、左心室内径明显增大,室间隔和/或左室壁节段运动异常,合并室壁瘤患者显示左心室下部心肌变薄,且向外膨出,呈矛盾运动;直接特征显示肌部室间隔不同大小回声失落;②彩色多普勒血流显像(CDFI)显示间接特征显示过二、三尖瓣五彩镶嵌反流束血流信号;直接特征显示过室间隔左向右五彩镶嵌反分流束血流信号;③自患者发病起CDE连续观察VSR直径在一定范围内逐渐增大;④实施VSR封堵术后CDFI仍显示过室间隔封堵器周围少量左向右五彩镶嵌分流束血流信号,但患者临床症状明显减轻。结论:急性心肌梗死并发VSR的CDE特征明显,CDE对急性心肌梗死并发VSR有特异性诊断价值。
Objective.. To probe into the imaging characteristics of with acute myocardial infarction complicated ventricular septal rupture （VSR） in color Doppler echocardiography （CDE）. Methods Thirty patients with acute myocardial infarction complicated VSR were examined with CDE. The CDE results were confirmed with 26 cases underwent angiocardiography, 19 cases received interventional.treatment for VSR, and 3 cases with coronary artery bypass graft and VSR repair. Re- suits： All the Thirty patierits with acute myocardial infarction complicated VSR were accurately diagnosed by CDE. The im- age features of CDE on patients with acute myocardial infarction complicated VSR were as follow;（1） Indirect sigh of two- dimensional echocardiography showed obvious enlargement of left atrium and left ventricle, abnormal segmental movement of ventricular septum or/and left ventricle wall. Cases complicated with ventricular aneurysm showed the thinning segment at the inferior part bulging outward, and signs of paradoxical movement. Direct sign was the echo loss of muscular ventric- ular septum with different size; （2） Color Doppler flow imaging showed indirect signs as the regurgitation of tricuspid and mitral valve, and direct signs as left to right shunt signal through ventricular septum; （3） The size of VSR may tend to in- crease from the onset with the time pass; （4） After VSR occlusion, there was still little shunt signal through Amplazer on CDE, but the patients symptoms were obviously lightened. Conclusion： The CDE characteristics are obvious and CDE is valuable and specific to the diagnosis with acute myocardial infarction complicated VSR.
出处
《医学影像学杂志》
2012年第1期42-44,共3页
Journal of Medical Imaging
关键词
室间隔穿孔
心肌梗死
彩色多普勒超声心动图
Ventricular septum repture
Myocardial in^arction~ Color Doppler echocardiography
