多普勒超声心动图对成人心肌致密化不全诊断价值的探讨

目的探讨超声心动图对心肌致密化不全（noncompaction of the ventricular myocardium,NVM）的诊断价值。方法采用超声心动图常规测量各腔室内径及心功能主要参数,分析二维、CDFI及频谱多普勒特点。结果①二维显示病变处心肌内外分为截然不同的两层,外层较薄,表现为回声较强的致密层,内层较厚,显示为为突出的肌小梁及深陷其问的隐窝,呈＂蜂窝状＂,好发于左心室心尖部、侧壁。左房室增大,可合并室壁隐窝或房室腔内血栓形成。②病变处心内膜呈波浪状。③M型超声心动图显示该处室壁运动幅度低平,收缩期室壁增厚率下降。④多普勒超声心动图显示深陷于肌小梁间的隐窝内可见血流信息,并与心室腔相通。结论NVM具有特征性超声改变,彩色多普勒超声心动图是无创、敏感诊断心肌致密化不全的首选方法。

The value of noncompaction of color echocardiogram in diagnosing noncompaction of ventricular myocardium

Objective To explore the diagnostic value and clinical significance of chocardiogram in noncompaction of ventricular myocardium（NVM）.Methods The diameter of tile chambers and the main indicators of cardiac function were measured in tile long-axis and short-axis view of tile left ventricle.apical four-chamber view.Two-dimensional,color and spectral Doppler characteristics were analyzed.Results ①Two-dimensional echocardiography showed significant difference between inside and outside at the location of hypokinetic myocardium：the outer layer was relatively thin and appeared as a compact layer with stronger echoes,whereas the inner layer was relatively thicker and appeared as prominent myocardial trabeculations and formation of intertrabeculations recesses deeply stucked in between them in the presence of ＂honeycomb＂.② The sites of anomal endocardium was in the shape of waves.③M-mode echocardiogram showed that the motion amplitude of locular wall at the above-mentioned location was relatively fiat and the increase rate of locular wall during the period of contraction descended.④The Doppler echocardiogram showed the information that there were visible blood streams witl1in the recesses deeply stuck between myocardial trabeculae and tl1ey were connected with left ventricle of heart chamber. Conclusion The ultrasonic changes of NVM was characteristic and the color Doppler echocardiography can be used as the first choice examination method for the diagnosis of NVM.