经食管超声心动图对窦性心律时右心耳血流频谱的研究

目的　应用经食管超声心动图技术 (TEE)观察窦性心律时右心耳结构、功能和血流频谱的特点。方法　选取 2 6例窦性心律患者 ,常规超声资料的留取后 ,采用经食管超声心动图技术 ,清楚显示右心耳图像并采集血流频谱。结果　窦性心律时右心耳血流频谱形态可分为 4相、 3相和 2相波 ,在获取的 2 6例图像中 ,右心耳血流频谱为 4相波者有 6例(2 3% ) ,为 3相波者有 12例 (4 6 % ) ,为 2相波者有 8例 (31% )。结论　窦性心律时右心耳血流频谱是反映右心房和右心耳功能的良好指标     

Evaluation of cardiac global function using the myocardial performance index by tissue Doppler echocardiography in patients with uremia.

OBJECTIVE: The purpose of this study was to assess global ventricular function in patients with uremia by means of the myocardial performance index (MPI) derived from tissue Doppler echocardiography. METHODS: According to the left ventricular mass index and pericardial effusion, 45 patients with uremia were classified into 2 groups: a uremia group and a uremia with pericardial effusion group. To calculate left ventricular MPI (LVMPI) and right ventricular MPI (RVMPI) by tissue Doppler echocardiography, the isovolumic contraction time (ICT), isovolumic relaxation time (IRT), and ejection time (ET) were measured at different sites in the mitral and tricuspid annuli. RESULTS: The mean ICT and IRT were longer, the ET was shorter, and the LVMPI and RVMPI were higher in the 2 disease groups than in a control group, and the indices were higher in the uremia with pericardial effusion group than in the uremia group. The increase of the LVMPI was more obvious than that of the RVMPI. There was a significant difference in the mean LVMPI and RVMPI among the 3 groups (P<.01). The MPI was positively correlated with the IRT and the sum of the ICT and IRT and negatively correlated with the ET. CONCLUSIONS: Both left and right ventricular systolic and diastolic function are impaired in patients with uremia. The MPI could be measured by tissue Doppler echocardiography, and we suggest that this index provides a novel, noninvasive method for clinical research on global myocardial performance in patients with uremia.     

彩色多普勒超声检测系统性红斑狼疮亚临床心脏异常

应用彩色多普勒综合性心脏超声方法检测３０例初发系统性红斑狼疮连续病例并与３０例健康对照组比较。结果显示ＳＬＥ组左室内径及室壁厚度较大；心室肥厚和／或扩张占３３％；左室充盈指标异常占４０％；瓣叶病变、心包积液和肺动脉高压分别占４３％、３７％和２７％。总异常率为８７％，远高于常规心电图及Ｘ线胸片。     

A congenital complex including muscular interventricular septal aneurysm in an adult: case report and review of literature

Muscular interventricular septum is an extremely rare location for congenital aneurysm. A 48-year-old patient with a muscular interventricular septum aneurysm coexisting with atrial septal defect, pulmonary stenosis and ventricular preexcitation is presented. Three-dimensional echocardiographic reconstruction of the lesion aided in a precise morphologic and quantitative assessment of the condition. The review of 10 previously reported patients with the entity is presented.     

经静脉心肌造影评价犬冠脉阻断后危险区和梗死区面积

目的探讨应用自制声学造影剂经静脉心肌造影在冠状动脉阻断后对危险区和梗死区面积测量的准确性.方法采用自制的声学造影剂,应用HP 5500超声诊断系统,选择左室短轴乳头肌切面,采用contrast程序,双触发间歇二次谐波成像,对12条开胸犬于冠状动脉阻断即刻和4 h后进行经静脉心肌造影研究.结果阻断即刻心肌造影显示的最大灌注缺损区面积(perfusion defected area,DA)占心脏短轴切面上左室壁心肌总面积百分比(DA%)为23.01±5.33,最小DA%为22.19±6.21,二者无显著差异(t=1.023,P=0.168).阻断4 h后最大DA%为22.20±3.77,与危险区面积(risk area,RA)占心脏短轴切面上左室心肌总面积的百分比(RA%)相关显著,r＝0.91. 阻断4 h最小DA%为8.80±3.45,与病理上梗死区(infarct area,IA)占心脏短轴切面上左室心肌总面积的百分比(IA%)相关显著,r＝0.85.结论心肌造影上灌注缺损最大面积反映危险区面积,而最小灌注缺损面积反映梗死面积.     

经食道超声诊断主动脉瓣单瓣畸形1例

患者男，48岁．间断胸痛伴阵发性呼吸困难5年．加重1个月。经胸超声心动图检查：左室内径明显增大．左房轻度增大，右房轻度增大．右室内径正常；室间隔及左室壁厚度增厚．室间隔运动减低，余室壁运动幅度尚可；主动脉瓣明显增厚、回声增强．瓣叶结构显示不清。CDFI显示舒张期主动脉瓣轻至中度反流信号．连续多普勒超声显示收缩期主动脉瓣上流速明显增快．压差增大。     

Contrast-enhanced agent detection imaging: value in the characterization of focal hepatic lesions.

OBJECTIVE: To assess the value of SH U 508A-enhanced agent detection imaging in the characterization of focal hepatic lesions. METHODS: Contrast-enhanced agent detection imaging was performed on 78 focal hepatic lesions: 34 hepatocellular carcinomas, 22 metastases, 9 hemangiomas, 9 abscesses, 3 cysts, and 1 focal nodular hyperplasia. After administration of SH U 508A, interval delay scanning with agent detection imaging was performed with intervals of approximately 7 seconds (phase I), 30 seconds (phase II), and 90 seconds (phase III) after the first arrival of the contrast agent to the liver. Two observers blinded to the final diagnosis reviewed selected images and assessed the enhancement patterns of the lesions. For quantitative analysis, we calculated the enhancement ratio of the lesions and the difference of enhancement between the lesions and the liver parenchyma. RESULTS: Agent detection imaging showed a distinctive enhancement pattern in focal liver lesions compared with that in the liver. Hepatocellular carcinomas were characterized by early enhancement (phase I) and washout (phases II and III; sensitivity, 94.1%; specificity, 93.2%; positive predictive value, 91.4%). Metastases showed peripheral rim or targetlike enhancement (phase I, phase II, or both) and a defect (phase III) and had sensitivity of 77.3%, specificity of 100%, and a positive predictive value of 100%. Hemangiomas showed peripheral nodular or inhomogeneous (phase I, phase II, or both) and gradually centripetal (phase II, phase III, or both) enhancement (sensitivity, 88.9%; specificity, 100%; positive predictive value, 100%). Abscesses were partially enhanced from phase I to phase III (sensitivity, 66.7%; specificity, 95%; positive predictive value, 85.7%). The results of the quantitative analysis of lesion enhancement were compatible with those of the qualitative analysis. CONCLUSIONS: SH U 508A-enhanced agent detection imaging may yield distinctive enhancement characteristics in focal liver lesions that would contribute positively to the characterization of these hepatic lesions.     

心电图、超声心动图与冠状动脉造影在冠心病诊断中的比较研究

目的 评价心电图(ECG)、超声心动图(UCG)对冠心病的诊断价值。方法 选择216例冠状动脉造影检查的患者，造影前行ECG检查，测ST—T；行UCG检查，测左室射血分数(LVEF)、左室短轴缩短率(FS)、舒张早期充盈峰(E)、舒张晚期充盈峰(A)、E／A比值。结果 ECG与UCG诊断冠心病敏感性分别为90．3％，98．6％，特异性分别为20．8％，11．1％。结论 ECG、UCG对冠心病的诊断具较高的敏感性，且无创、费用低，可作为冠心病诊断的基本方法。     

经静脉声学造影剂增强乳腺肿块彩色血流信号的初步研究

本文探讨经静脉声学造影剂对乳腺肿块彩色血流信号的增强作用及鉴别良恶性病变的应用价值。１０例患者中７例为乳腺癌，３例为良性肿块，经静脉注射声学造影剂后，病灶区彩色血流信号显著增强：６例乳腺癌和１例良性肿块病灶内见有片状彩色血流区，血管数增多２～６条；１例直径＜１．０ｃｍ的乳腺癌见有１条彩色血流束；２例良性肿块中１例无彩色信号而另１例仅有１条血管。结果提示：经静脉声学造影剂能显著增强乳腺肿块彩色多普勒血流信号，更准确地反映肿块血供状况；有助于准确鉴别乳腺良、恶性病变。