| 左蕾刘丽文△ 张军李军朱永胜周晓东李红玲.超声心动图对心肌致密化不全的诊断及临床意义探讨[J].,2011,11(6):1142-1144 |
| 超声心动图对心肌致密化不全的诊断及临床意义探讨 |
| Application of Echocardiography in Diagnosis of Noncompaction ofVentricular Myocardium and Its Clinical Significance |
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| DOI： |
| 中文关键词: 心肌致密化不全 超声心动图 |
| 英文关键词: non-compaction ventricular myocardium echocardiography |
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| 中文摘要: |
| 目的：探讨超声心动图对心肌致密化不全的诊断及临床意义。方法：应用Vivid7、HP5500 彩色多普勒超声诊断仪（探头频率
为2～4MHz）对32 例左室心肌致密化不全患者进行检查，采用二维、M 型、彩色及频谱多普勒观察病变心肌及心内膜改变，重点
观察心尖段。常规测量各腔室内径、左室壁正常段心肌厚度及动度，评价心室舒张功能、计算左心室射血分数EF 及瓣膜反流等基
本信息。结果：①受累的心室内膜面可见多发异常粗大的、呈蜂窝状的肌小梁和交错深陷的隐窝形成网状结构。②病变区域心室
壁外层的致密心肌明显变薄，为中低回声，较正常心肌薄2~4mm，其心肌厚度<6mm，而内层心肌疏松增厚为强回声。③病变以近
心尖部1/3 室壁节段最为明显，很少累及室间隔及基底段室壁。④彩色多普勒可示隐窝间隙之间有低速血流与心腔相通。⑤多数
患者以渐进性的心功能不全、呼吸困难、体循环栓塞、心律失常为主要表现，本组患者临床表现为心力衰竭22 例，心脏杂音3 例，
心律失常2 例，5 例无明显不适症状。结论：超声心动图检查是准确、无创诊断心肌致密化不全的首选方法，能够对房室结构和心
功能进行全面评价，有助于明确心力衰竭病因并协助治疗，同时也有助于筛查心肌致密化不全家族，对临床治疗起着很好的指导
作用。 |
| 英文摘要: |
| Objective: To explore the clinical value of echocardiography in diagnosing non-compaction ventricular myocardium
(NVM). Methods: A total of thirty-two patients with NVM were included in this study. The changes of myocardial and endocardial lesion
in left ventricle, especially in apex, were observed by 2-dimensional, M-type, color doppler and spectrum doppler echocardiography by
GE vivid7 and HP 5500 ultrasonic diagnositic system. Internal diameters of each cavity and thickness/movement of normal myocardium
of the left ventricle were routinely measured. Then the diastolic function, left ventricular ejection fraction and valvular regurgitation were
also assessed. Results: 1. Reticular formation which was made up by abnormally thick, honeycombed trabecular muscle and staggered
deep crypt could be seen in the endocardium of left ventricle that was involved by NVM. 2. The outer nontrabeculated compacted ventricular
myocardium layer got thinner obviously, when the inner noncompacted trabeculated layer got thicker. 3.Lesions in the lower 1/3
ventricular wall which near the apex appeared most severe. Interventricular septum and basal segment of ventricular wall were rarely
involved.4. The dim low-speed blood flow between crypt communicated with cavity was detected by color doppler imaging. 5. In all thirtytwo
NVM patients, twenty-two with heart failure, three with cardiac murmur, two with arrhythmia and five normal. Conclusion: The
examination of echocardiography was the preferred way in diagnosing NVM accurately and non-invasively. It could fully evaluate the
structure of atrium and ventricle of heart as while as cardiac function, and could help to find the cause of heart failure and to treat the patients.
Meanwhile, it also could help to screen the family of NVM and to guide the clinical treatment. |
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