心肌结核伴心包炎的超声表现1例

患者男,75岁。主因反复咳漱,咳痰1年加重两个月,咯血痰一周于2004年9月入院。既往史:30年前患肺结核。查体,T:36.2℃,P:102次/min,双肺呼吸音粗糙,可闻及散在干鸣及水泡音。肺CT:双肺上中下可见斑片影,彩超所见:心尖四腔心切面可见室间隔与心尖交界部右室侧的心肌3.3cm×2.3cm大小混合性回声,边界清晰,其内可见多个低回声,局部放大后的图像可见其钙化及液化灶,破坏的心肌边界呈蚕食样改变(图1)。同时可见左室侧壁脏壁层心包腔无回声区1.0~2.1cm,心包膜较光滑(图2)。超声诊断:心肌炎性病变(TB可能性大)。该患者经过近10个月的抗结核治疗临…     

超声心动图诊断右室心肌致密化不全1例

患者女,42岁,因渐进性心慌、气短伴双下肢轻度浮肿半年来院就诊。临床听诊:胸骨右缘第Ⅲ~Ⅳ助间可闻及Ⅱ级收缩期杂音;心电图示完全性右束支传导阻滞;超声心动图检查:右房、右室增大,右室腔内(心尖部、室间隔心尖段、前壁)可见增粗的肌小梁,小梁间见大小不等深陷的间隙,其内血流与右室相通(图1)。右室前壁,心尖部心肌收缩运动减弱。彩色多普勒血流显示三尖瓣中度反流,余各瓣膜未见异常。超声心动图提示:右室腔内丰富的肌小梁,右室心肌多节段运动减弱,考虑右室心肌致密化不全。初一月,心脏冠状动脉循环形成前,胚胎心肌是由海绵心肌组成,心腔…     

超声诊断左室心肌致密化不全1例分析

对我院超声诊断左室心肌致密化不全1例分析如下。 1病历摘要 女,48岁。劳累时出现心悸气短,并逐渐加重。查体：订唇青紫,心尖部闻及二级收缩杂音;X线：心脏扩大;心电图：ST—T下移;彩色超声心动图检查：左心增大,左室内经：60mm,左房内径：41mm,左室腔内（心尖部、前间壁、前壁）无数突出增大的肌小粱,错综排列,呈网状回声,     

胎儿先天性心脏横纹肌瘤1例的超声表现

患者女 ,3 1岁。孕 2 7周。产前超声检查 ,仪器Acuson Sequoia5 12型彩色多普勒超声仪 ,探头频率3 .5 MHz。超声所见 :胎儿双顶径 7.2 cm,脊柱排列整齐 ,股骨长径 4 .8cm,胎心率 14 6次 / min,胎盘位于子宫前壁 I级 ,羊水指数 2 6.6cm。肝、双肾、胃泡、膀胱、肠管均可见。胎儿     

左室心肌致密化不全1例

患者男,37岁,因心悸气短7年入院.查体:BP 105/70 mmHg,口唇无紫绀,无贫血外貌.心界向左下扩大,未闻及病理性杂音.心电图:窦性心律,心肌缺血.冠脉造影:冠状动脉未见病变.     

左室心肌致密化不全1例报告

左室心肌致密化不全（LVNC）为一种罕见的遗传性心肌病,年发病率为0.05%~0.24%,男性多于女性,以渐进性心功能不全、心律失常、血栓栓塞为主要临床表现。LVNC临床上罕见且诊断时往往已经到终末期,预后较差,但若能尽早诊断,积极采取治疗,也可延缓病程的进展。现报道LVNC患者一例,旨在提高对该疾病的认识,提高早期诊断效率。     

胎儿左心室心肌致密化不全,并心尖部室壁瘤1例

作者：姜莲 电话：13609431277 E-mail：1285011654@qq.com     

胎儿完全性心内膜垫缺损超声表现1例

孕妇，24岁。孕28周，孕1产0。既往史：孕早期高热，外院治疗情况不详。到我院常规产前超声检查：右上腹见清晰胎头光环，双顶径：69mm，头围：266mm，脑中线居中，侧脑室未见扩张；唇线连续完整；心胸比例正常，四腔心切面上，心内膜垫十字交叉消失（图1），房间隔下部和室间隔上部缺失，左右房室瓣异常（图2），形成一较大的房室通道；彩色多普勒超声所见：     

超声诊断心肌致密化不全并二尖瓣脱垂1例

1病历摘要 患者，女，17岁，学生，平素体健。校内常规体检，心前区听诊闻及收缩期杂音，疑先天性心脏病来院做进一步检查。查体：脉搏90次／min，律齐，血压110／80mmHg，听诊心前区闻及收缩期喀喇音和收缩晚期杂音。心电图检查：窦性心率，正常心电图。采用GEVIVID-7彩色超声诊断仪，M3S探头，频率1．7-3．4MHz。超声所见：左室轻扩大，心尖部及左室侧后壁心肌为无数突出增大的肌小梁，     

胎儿肥厚型心肌病超声表现1例

孕妇29岁，孕2产1，孕41周。上诉外院超声榆查发现胎儿心腔内异常血流信号，为明确诊断来本院进一步俭查。我院胎儿超声心动图示：胎儿心胸比例大致正常（0．43），心尖朝向左侧。四腔观显示：室间隔呈梭形肥厚，回声欠均匀，最厚处位于室间隔中部，达16mm（图1）。     

Recurrent pheochromocytoma with catecholamine cardiomyopathy and left ventricular thrombus: a case report

Pheochromocytoma is a rare and usually benign tumor of the adrenal glands. We report a case of a 40-year-old woman with recurrent pheochromocytoma and catecholamine cardiomyopathy. She had no history of other types of tumors or connective tissue disease. She had already undergone surgery twice to remove the pheochromocytoma, which had now recurred for the second time. A thrombus in the left ventricle was also noted upon imaging examination, which dissipated after anticoagulation therapy using dabigatran, allowing the patient to opt for an elective third surgery. This paper describes the clinical outcome of using the anticoagulant dabigatran to treat left ventricular thrombosis in this rare case of recurrent pheochromocytoma, and thus further contributing to the knowledge of the clinical management of this rare and complicated disease.     

左室心尖部室壁瘤的鉴别诊断

左室心尖部室壁瘤大部分为心肌梗死后的并发症，超声心动图在室壁瘤的诊断中具有较高敏感性和特异性，但由于检查者对少见相关疾病认识不足而容易造成误诊，本文通过回顾分析室壁瘤超声图像与相关临床资料，鉴别出部分误诊为室壁瘤的少见病和正常变异，如：假性室壁瘤、左室憩室、肌间裂隙、应激性心肌病，详细总结上述少见病的基本特征，有助于帮助基层超声医师提高心尖部病变的诊断能力。     

成人左心室先天性室壁瘤1例

病例女,42岁.间断性胸闷半年,每次发作约半小时缓解.偶有背部酸胀感,无胸痛,无恶心、呕吐,与活动关系不大.心率65次/min,血压100/65mmHg.既往体健,否认心脏病家族史及心脏外伤史.     

胚胎性横纹肌肉瘤超声表现1例

患儿男,2岁,因外伤半个月后发现左小腿肿块就诊。体格检查患儿左小腿可扪及一大小约8 cm×5 cm的无痛性肿块,质硬,活动度较差,边界不清,外表皮肤正常,无溃疡,皮温稍低,下肢血运较好,活动度可。超声检查：皮下0.9 cm处比目鱼肌内见范围7.4 cm×3.1 cm×2.5 cm混合回声区,呈梭形,形态尚规则,边界尚清,内部回声欠均,以高回声区为主,可见纤维条索样稍高回声及边缘性小片状低回声;     

Left ventricular apical and atrial appendage thrombus with hypertrophic cardiomyopathy in sinus rhythm: a case report

A 47-year-old female with a history of untreated hypertension and diabetes mellitus was referred because of a left ventricular echocardiographic mass with congestive heart failure. At the time of admission, she had already had a cardio-embolic stroke with loss of recent memory and slight paralysis of the right upper arm. It was difficult to distinguish between thrombus and tumor. However, her clinical condition required surgical resection as soon as possible. We performed cardiac CT to evaluate the coronary arteries and to scan the mass at the left ventricular apex. This CT evaluation revealed another mass at the left atrial appendage. Thus, these two masses were highly suggestive of thrombi. Subemergency surgical resection of the two masses and a part of the myocardium at the left ventricular apex was successfully performed. The pathological results showed that both the mass in the left ventricular apex and the mass in the left atrial appendage were thrombi, and the myocardial disarray confirmed the echocardiographic diagnosis as hypertrophic cardiomyopathy.     

Advanced Anderson-Fabry disease presenting with left ventricular apical aneurysm and ventricular tachycardia

A 54-year-old female with Anderson-Fabry disease(AFD)-R342 Q missense mutation on exon 7 in alphagalactosidase A(GLA) gene- presented with sustained ventricular tachycardia. Imaging confirmed the presence of a new left ventricular apical aneurysm(LVAA) and a significantly reduced intra-cavitary gradient compared to two years prior. AFDcv is an X-linked lysosomal storage disorder caused by GLA enzyme deficiency. The phenotypic expression of AFD in the heart is not well described. Cardiac involvement can include left ventricular hypertrophy(LVH), which is typically symmetric, but can also mimic hypertrophic cardiomyopathy(HCM). Left ventricular apical aneurysm is a rare finding in HCM. We suggest a shared mechanism of LVAA formation in AFD and HCM, independent of the underlying cardiomyopathy. Mechanisms of LVAA formation in HCM include genetic predisposition and long-standing left ventricular wall stress from elevated intra-cavitary systolic pressures due to mid-cavitary obstruction. Both mechanisms are supported in this patient(a brother with AFD also developed a small LVAA). Screening for AFD should be considered in cases of unexplained LVH, particularly in patients with the aneurysmal variant of HCM.