房间隔膨出瘤合并畸形的彩色多普勒超声心动图特征及规律性研究

目的：探寻房间隔膨出瘤（IASA）合并畸形的彩色多普勒超声心动图（CDE）特征及规律性。方法：应用CDE检查32例IASA，在经胸超声心动图（TTE）检查之后18例又行经食管超声心动图（TEE）检查。10例行合并畸形房间隔缺损（ASD）封堵术，16例行合并畸形手术治疗。结果：根据CDE特征对32例IASA及合并畸形全部做出正确诊断。IASA及合并畸形CDE特征及规律性明显：①二维超声心动图（2DE）心尖四腔心切面、胸骨旁四腔心切面和剑下四腔心切面显示房间隔中部变薄，局部向右心房或左心房凸出，并随心动周期摆动；②IASA多并畸形，在合并畸形中ASD（84．4％）多见，其次是室间隔缺损（12．5％）和房间隔卯圆孔未闭（6．3％），还有法乐三联症、法乐四联症、室间隔完整的肺动脉闭锁和主动脉瓣狭窄等，但少见；③孤立性IASA患者2DE显示心腔内径正常；合并ASD患者2DE显示右心房、右心室内径增大，彩色多普勒血流显像显示过房间隔左向右五彩镶嵌分流束血流信号；合并室间隔缺损2DE显示左心房内径增大，彩色多普勒血流显像显示过室间隔左向右五彩镶嵌分流束血流信号；④TIE很难准确显示IASA合并ASD的数目、大小和位置；TEE可准确显示IASA合并ASD的数目、大小和位置；⑤IASA女性（75．0％）明显多于男性（25.0％）。结论：CDE对IASA有特异性诊断价值。应用CDE明确判断合并畸形比诊断IASA更重要；应用TEE判断合并畸形SD比TIE更具有特异性诊断价值。

Study on characteristics and regularity of color Doppler echocardiography on interatral septal aneurysm and deformity

Objective：To probe into the imaging characteristics and regularity of interatral septal aneurysm （IASA） and deformity in color Doppler echocardiographic （CDE）. Methods：Thirth-two cases of interatrial septum aneurysm （IASA） were investigated with color Doppler Echocardiography, with 18 cases underwent transesophageal echocardiography （TEE） following transthoracic echocardiography （TIE）, 10 cases underwent occlusion therapy for associated ASD and 16 cases underwent operation for associated abnormalities. Results： Thirty-two cases were accurately diagnosed by imaging character of CDE. The features of CDE image in IASA were obvious. ① Two dimensional echocardiographic （2DE） apical four chamber view, parastemal four chamber view and subappendix four chamber view showed a thinning part in the middle of interatfial septum, its projecture toward right or left atrium and its swing to and fro during cardiac cyclel ② Associated abnormalities were frequently seen in IASA, with ASD （84.4%） as the most common abnomality, VSD （12.5%） and patent foramen ovale （6.3%） as the second and Fallot＇ s trilogy, Fallot＇ s tetrad, pulmonary artery atresia with intact interventricular sepmm and aortic stenosis as the rare abnormalities; ③ In isolated IASA, 2DE showed normal internal diameters of heart chambers; in those with associated ASD, 2DE showed enlarged right atrium and right ventricle and Color Doppler Flow Imaging showed multicolor shunt flow signal across interatrial septum; and in those with associated VSD, 2DE showed enlarged left atrium and Color Doppler Flow Imaging showed multicolor shunt signal across interventrlcular septtan; ④ The number, size and position of associated ASD were hard to be showed by TTE but could be accurately showed by TEE; ⑤ Female IASA （75.0%） were more significant than male IASA （25.0%）. Conchlsion：CDE bes specific value in diagnosing IASA. It is more important to judge associated abnormalities titan to diagnose IASA with CDE and TEE is