彩色多普勒超声在肺栓塞鉴别诊断中的临床价值

目的探讨彩色多普勒超声在肺栓塞鉴别诊断中的应用价值。方法经临床诊断的肺栓塞、肺心病、先天性房间隔缺损、右室心肌致密化不全、原发性肺动脉高压患者5组（共154例）行彩色多普勒超声检查，观察心内结构，估测肺动脉压力。结果各组患者右房、右室均增大，肺动脉压力增高。慢性肺栓塞患者可见右室壁及室间隔增厚。急性肺栓塞患者有室壁增厚不明显，部分患者可见肺动脉内栓子形成，肺动脉频谱形态改变。肺心病患者心脏图像显示欠清晰，右室壁增厚，部分心功能减低。房缺患者在房间隔不同部位可见回声连续性中断。右室心肌致密化不全患者右心室内膜面可见粗大的肌小梁和其间深陷的隐窝。原发性肺动脉高压患者除右房、右室内径增大外，心内未见其他畸形。结论彩色多普勒超声在肺栓塞鉴别诊断中具有重要的临床意义。

Clinic value of color Doppler ultrasound in differentiated diagnosis of pulmonary embolism

Objective To explore the application value of color Doppler ultrasound in differential diagnosis of pulmonary embolism （PE） . Methods One hundred and fifty - four patients were divided into 5 groups, including pulmonary embolism （ PE ） , chronic respiratory disease （ CRD ）, atrial septal defect （ ASD ）, noncompaction of the ventricular myocardium （NVM） and primary pulmonary hypertension（PPH）. All the patients underwent color Doppler uhrasonography, then the cardiac structure was observed, pulmonary pressure was measured. Results The right atrium （RA）, right ventricle （RV） and pulmonary pressure were increased in all the groups, thickening of RV wall and interventricular septum （IVS） could be detected in patients with chronic PE, while it was not obvious in patients with acute PE. And pulmonary thrombosis and the changes of pulse wave shape could be detected in part of these patients. The cardiac imaging was not clear, RV wall was thickened and cardiac function was decreased in partial patients with CRD. Different part of interatrial absence could be detectd in ASD. Numerous prominent trabeculation and deep intertrabecular recesses could be observed in NVM patients. There was no other malformation except enlarged RA and RV in patients with PPH. Conclusion Color Doppler ultrasound has important clinical value in differential diagnosis of PE.