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心肌致密化不全并先天性心脏病彩色多普勒超声心动图特征及规律性研究 总被引:3,自引:0,他引:3
目的:探讨心肌致密化不全(NVM)并先天性心脏病彩色多普勒超声心动图(CDE)特征及规律性.方法:应用CDE诊断仪检查NVM并先天性心脏病患者31例,28例经心血管造影对照,15例行介入治疗,9例行手术治疗.结果:NVM并先天性心脏病CDE特征及规律性明显:①二维超声心动图显示NVM病变部位心肌呈"蜂窝状"改变,称2DE"蜂窝征",在2DE"蜂窝状"间隙内充满彩色多普勒血流显像五彩镶嵌血流信号.②并先天性心脏病的NVM以右室型为多见.左室型和双室型少见.③在并先天性心脏病中以继发孔房间隔缺损多见,还有动脉导管未闭、肺动脉瓣狭窄、Ebstein畸形、法洛三联症、部分房室隔缺损、室间隔缺损、主动脉左室遂道、主动脉窦瘤破裂、Lutembacher综合征和三尖瓣脱垂等,但少见.④多数NVM引起病变侧房室瓣关闭不全.⑤中度和重度NVM可致病变侧心室收缩功能降低.⑥多数NVM并发不同类型心律失常.结论:NVM并先天性心脏病的CDE特征及规律性明显,CDE对NVM并先天性心脏病有特异性诊断价值. 相似文献
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目的 :探讨超声心动图检测室间隔缺损 (室缺 )并发畸形的价值。方法 :将手术证实的室缺并发畸形与超声检查进行比较 ,分析超声检测敏感度、特异度及准确度。结果 :超声心动图检出室缺并发畸形的敏感度为 5 8.8% ,特异度 92 .9% ;准确度 80 .6 %。结论 :室缺并发卵圆孔未闭及并发右室流出道较易漏诊 ,其他一些少见并发畸形多因主观忽视而漏诊。注意全面扫查及改善检查技巧有助于提高室缺并发畸形的检出和减少误诊。 相似文献
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目的探讨应用彩色多普勒超声快速筛查胎儿先天性心脏疾病的方法。方法对6 307例孕22~28周的孕妇进行系统胎儿超声检查,重点观察胎儿心脏。心脏检查方法:确定胎方位,确定胃泡与肝脏的位置,采用四腔心切面头侧偏转法获得四腔心、左室流出道、右室流出道、三血管或三血管气管切面,如有异常者进行超声心动图检查,用顺序节段法进行分析。结果检出心脏畸形32例,孕周在22~25周,胎儿处于脊后位时检查时间最短。结论四腔心切面头侧偏转法是一种简单、快速、易掌握、可靠的胎儿心脏筛查方法,孕周在22~25周,胎儿处于脊后位时检查,可提高筛查速度,减少漏诊率。 相似文献
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彩色多普勒超声心动图对主动脉窦瘤的诊断价值 总被引:4,自引:0,他引:4
目的 :旨在探讨彩色多普勒超声心动图 (CDE)诊断主动脉窦瘤的临床价值。方法 :观察分析 115例主动脉窦瘤CDE图像特征及规律性并与手术对照。结果 :95例源于右冠状动脉窦 ,19例源于无冠状动脉窦 ,1例源于左冠状动脉窦 ;窦瘤破入右心室 95例 ,破入右心房 18例 ,破入左心室 1例 ,破入室间隔 1例。合并室间隔缺损 79例 ,主动脉瓣脱垂及反流 5 5例 ,心内膜炎 2 9例 ,其它房间隔缺损、动脉导管未闭分别为 4、9例。术前CDE诊断结论与手术符合率达 99% ,合并室间隔缺损的检出率为 91%。本组合并室间隔缺损占整个病例的 68% ,占窦瘤破入右心室的 84%之多。合并主动脉瓣脱垂或反流本组检出率高于手术所见 (62 /5 5 )。结论 :CDE可以判明主动脉窦瘤的精确的解剖 ,包括窦瘤的来源部位、形态、大小、血流动力学影响 ,是否合并其它心脏畸形等。患者经CDE检查后不必作其他辅助性诊断检查就进行手术是安全、准确、可靠的。 相似文献
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目的探讨彩色多普勒超声心动图(CDE)在主动脉窦瘤破裂(RASA)封堵术中的价值。方法应用CDE筛选15例RASA适应证实施封堵术,封堵术中应用CDE监测,封堵术后应用CDE判断疗效并跟踪随访。结果根据CDE图像特征表现对15例RASA中的主动脉哪个窦破入到哪个心腔及合并畸形全部做出正确诊断,CDE筛选的15例RASA实施封堵术全部获得成功。结论 CDE在RASA封堵术中具有重要临床价值,术前应明确指出主动脉哪个窦破入到哪个心腔、破口直径及除外合并室间隔缺损是封堵成功的关键;术中监测和术后判断封堵器位置是否正常,有无过破口处残余分流束血流信号以及封堵器是否影响主动脉瓣的功能很重要。 相似文献
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900例胎儿超声心动图诊断胎儿先天性心脏病的体会 总被引:2,自引:0,他引:2
目的 探讨胎儿超声心动图对胎儿期先天性心脏病的诊断方法及应用价值。方法 1989年 11月~ 2 0 0 0年 11月对 90 0名高危孕妇行胎儿超声心动图检查。孕妇年龄 2 2~ 39岁 (2 7 9岁± 3 9岁 ) ,孕期 2 0~ 42周 (33 4周± 4 8周 )。首先应用二维超声心动图 (2DE)探察 ,横切胎儿胸部取标准四腔切面作为基础切面 ,旋转探头方向获取五腔心、大动脉短轴、左室长轴、主动脉弓长轴、下腔静脉长轴等切面 ,在清晰的切面图像上叠加彩色多普勒信号 ,观察心内有无异常血流 ;以脉冲多普勒记录主、肺动脉瓣及二、三尖瓣血流频谱或异常湍流频谱。结果 胎儿期先天性心脏病发病率3 78% (34 / 90 0 ) ,胎儿超声心动图诊断胎儿先天性心脏病的敏感性 92 %、特异性 95 %、阳性预测值 91%、阴性预测值96 %。结论 胎儿超声心动图诊断胎儿先天性心脏病的敏感性、特异性高 ,为妇产科及儿科医生提供有价值的资料 ,应作为高危孕妇的常规检查 相似文献
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目的 :分析永存动脉干 ( PTA)结构、血流动力学特征 ,并探讨切面的选择。方法 :应用彩色多普勒超声仪检测11例疑诊为 PTA患者的二维超声心动图 ( 2 DE)和彩色多普勒血流图 ( CDFI)。所有患者均使用剑突下、胸骨旁和胸骨上窝多部位和多切面检查心内结构。结果 :10例确诊为 PTA,1例诊断为肺动脉闭锁 ,心血管造影证实 11例均为 PTA。PTA 型 2例 , 型 1例 , 型 4例 , 型 4例。PTA起源左右心室之间 5例 ;主要起源于右心室 6例 ,骑跨率≥ 60 %。PTA双叶和四叶各 1例 ,三叶 9例。结论 :2 DE和 CDFI可用于识别 PTA病理解剖结构 ,血流动力学特征 ,且诊断符合率高 ( 91% ) 相似文献
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目的 探讨超声心动图[经胸超声(TTE),或经食管超声(TEE)]诊断先天性左房室瓣穿孔价值.方法 对3例经TTE或TEE诊断的成人先天性左房室瓣穿孔患者的超声心动图诊断资料进行分析,将超声结果与手术结果进行对照.结果 3例成人先天性左房室瓣叶穿孔所致的左房室瓣关闭不全病例,由于本组的发病年龄,临床上需要与先天性心脏瓣膜病(风湿性及其他)鉴别,临床及超声发现其他先心病的证据,尤其是TTE或TEE二维超声显示瓣叶中断,及彩色多普勒血流显像显示瓣膜偏心性高速血流,且临床上可以排除感染性心内膜炎,皆有助于先天性左房室瓣穿孔诊断.结论 TTE和TEE检查是早期诊断先天性左房室瓣穿孔的首选方法.TEE检出先天性左房室瓣穿孔优于TTE. 相似文献
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超声心动图在三尖瓣闭锁中的诊断价值 总被引:1,自引:0,他引:1
三尖瓣闭锁(TA)是一种少见的发绀型先天性心脏病,发病率占先天性心脏病的1%~3%[1,2].目前其诊断主要是通过超声心动图得出. 相似文献
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目的探讨彩色多普勒超声在卵巢肿瘤蒂扭转中的应用价值。方法回顾性分析彩色多普勒超声诊断并经手术及病理证实的卵巢肿瘤蒂扭转21例。结果21例卵巢肿瘤蒂扭转中超声正确诊断18例,诊断符合率85.71%,误诊率为14.29%(3/21)。结论彩色多普勒超声对卵巢肿瘤蒂扭转具有较高的诊断价值,可为临床诊治提供重要依据。 相似文献
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Lindsay Rogers M.D. Jun Li M.D. Liwen Liu M.D. Ph.D. Rula Balluz M.D. M.P.H. Jack Rychik M.D. Shuping Ge M.D. 《Echocardiography (Mount Kisco, N.Y.)》2013,30(4):428-438
In this article, we review a number of topics that we believe reflect new and exciting aspects of fetal echocardiography. These new advances include early fetal cardiovascular imaging around 14 weeks, the utility of three/four dimensional imaging technology for the fetus, and finally the utility of fetal echocardiography for antenatal and perinatal care of congenital heart diseases to improve and optimize outcome. Finally, we briefly discussed future directions in fetal cardiac intervention. 相似文献
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Syed A. Agha MD Andreas P. Kalogeropoulos MD Jeffrey Shih MD Vasiliki V. Georgiopoulou MD Grigorios Giamouzis MD PhD Perry Anarado MD Deepa Mangalat MD Imad Hussain MD Wendy Book MD Sonjoy Laskar MD Andrew L. Smith MD Randolph Martin MD Javed Butler MD MPH 《Journal of cardiac failure》2009,15(7):586-592
BackgroundIncremental value of echocardiography over clinical parameters for outcome prediction in advanced heart failure (HF) is not well established.Methods and ResultsWe evaluated 223 patients with advanced HF receiving optimal therapy (91.9% angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, 92.8% β-blockers, 71.8% biventricular pacemaker, and/or defibrillator use). The Seattle Heart Failure Model (SHFM) was used as the reference clinical risk prediction scheme. The incremental value of echocardiographic parameters for event prediction (death or urgent heart transplantation) was measured by the improvement in fit and discrimination achieved by addition of standard echocardiographic parameters to the SHFM. After a median follow-up of 2.4 years, there were 38 (17.0%) events (35 deaths; 3 urgent transplants). The SHFM had likelihood ratio (LR) χ2 32.0 and C statistic 0.756 for event prediction. Left ventricular end-systolic volume, stroke volume, and severe tricuspid regurgitation were independent echocardiographic predictors of events. The addition of these parameters to SHFM improved LR χ2 to 72.0 and C statistic to 0.866 (P < .001 and P = .019, respectively). Reclassifying the SHFM-predicted risk with use of the echocardiography-added model resulted in improved prognostic separation.ConclusionsAddition of standard echocardiographic variables to the SHFM results in significant improvement in risk prediction for patients with advanced HF. 相似文献
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目的评价彩色多普勒超声心动图对主动脉夹层动脉瘤(AD)的诊断价值。方法应用彩色多普勒超声心动图对18例疑诊AD的患者进行检查。结果17例经超声检查准确诊断。AD者主动脉均增宽,主动脉壁分离形成真、假两腔,可见内膜片回声;彩色多普勒能直接观察血流由撕裂口进入假腔以及真、假腔内血流变化,并能评价主动脉瓣返流程度。结论彩色多普勒超声心动图能快速、安全、准确地检出本病,对诊断本病具有重要价值。 相似文献
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《Indian heart journal》2018,70(1):71-74
ObjectiveTo study the echocardiographic features of criss-cross heart (CCH), a congenital cardiac anomaly characterized by crossed ventricular inflow streams, in Indian patients.MethodsIn this retrospective observational study, all pediatric echocardiograms performed in a single tertiary care institution in South India over a three-year period were scrutinized for a diagnosis of CCH. Demographic, clinical and echocardiographic data were collected from patients’ medical records and echocardiographic database. Crossed ventricular inflow streams was identified when there was inability to visualize both atrio-ventricular valves in a single imaging plane in cardiac four chamber view.ResultsCCH was diagnosed in five patients from 10,500 pediatric echocardiographic studies. The age at diagnosis ranged from one month to 8 years. Cyanosis was present in all but one of the five cases. Crossed ventricular inflow streams was present by definition in all cases, whereas superior-inferior ventricular relationship was present in only three cases. All cases were associated with ventricular septal defects. Atrio-ventricular discordance was seen in three cases and concordance in two. Ventriculo-arterial discordance was seen in three cases, concordance in one and double outlet right ventricle in one. Three cases had pulmonary stenosis and the other two had pulmonary arterial hypertension. Straddling of AV valve was observed in four cases and hypoplastic aortic arch in one case.ConclusionCCH is an extremely rare congenital cardiac anomaly. Superior-inferior ventricular relationship often co-exists with CCH, but is not necessarily present in all cases. CCH requires early diagnosis because of its common association with diverse cardiac anomalies. 相似文献