二维及三维超声心动图诊断单纯性二尖瓣前叶裂

目的 通过二维及三维实时超声心动图探讨单纯性二尖瓣前叶裂的诊断特点,进一步确认二尖瓣前叶裂的超声诊断标准.方法 对26例单纯性二尖瓣前叶裂患者的二维及三维实时超声心动图图像进行分析,观察裂的形态、位置及二尖瓣反流等.结果 26例患者中,23例二尖瓣前叶裂位于近联合处,3例位于二尖瓣前叶中间;8例合并二尖瓣脱垂及腱索断裂;15例二尖瓣前叶裂呈近"I"型,11例呈近"C"型或"S"型;5例二尖瓣口未见反流信号,9例伴二尖瓣中度以上反流.结论 动态图像下二尖瓣短轴切面显示二尖瓣前叶不连续,可探及回声失落处,是二尖瓣前叶裂的特异性诊断特点.二尖瓣裂致二尖瓣关闭不良者彩色多普勒显示二尖瓣反流源于裂口处.连续扫查二尖瓣配合三维超声心动图可以清晰显示二尖瓣裂的位置、形态以及程度.

Two-dimensional and three-dimensional echocardiography in diagnosis of isolated anterior mitral cleft

Objective To explore the features of isolated anterior mitral cleft with two-dimensional (2D) and three-dimensional real-time echocardiography (RT-3DE), and to establish ultrasonic diagnostic standards of isolated anterior mitral cleft. Methods 2D echocardiography and RT-3DE images of 26 patients with isolated anterior mitral cleft were analyzed, including the shape and location of the cleft, mitral regurgitation (MR) and so on. Results Among 26 patients with isolated anterior mitral clefts, clefts of 23 patients located near the commissure of mitral valve, 3 were on the middle part. Clefts combined with mitral valve prolapse and rupture of chordae tendineae were detected in 8 patients. For the shape of the cleft, 15 were like "I", the others liked "C" or "S". Five cases were found without MR, while 9 with moderate-severe MR. Conclusion A discontinuous anterior mitral valve with an echo-lost in the video image along mitral valve short-axis is confirmed as the specific diagnostic feature for isolated anterior mitral cleft. Color Doppler flow imaging shows that the regurgitant jet originate from the cleft. Continuous 2D echocardiographic scan with the help of RT-3DE can demostrate clearly the position, shape and extent of isolated anterior mitral cleft.