心肌致密化不全的超声特征分析

目的 进一步明确超声心动图对心肌致密化不全(NVM)的诊断标准。 方法 总结分析17例NVM患者的超声表现并与10例高血压性心肌肥厚患者比较。 结果 NVM的超声特征包括:1)致密化不全的室壁可见二层结构:薄层的心外膜致密化带及相对较厚的心内膜致密化不全层,后者由突出的肌小梁及深陷的小梁间隐窝组成,NVM患者收缩末期致密化不全层与已致密化层厚度的最大比率>2:2)左室致密化不全部位通常在心尖段、侧壁中段及下壁中段,右室在心尖段及游离壁中段。除受累节段的室壁运动减弱外,部分形态学正常的节段收缩活动也受到影响,最终导致心室总功能的下降;3)彩色多普勒显示心腔内血流直接进入小梁间的隐窝。 结论 NVM在超声心动图上有特征性的表现,超声是诊断NVM首选的及最佳的方法。

Echocardiographic characteristics of noncompaction of ventricular myocardium

Objective To establish the diagnostic criteria of echocardiography for noncompaction of ventricular myocardium (NVM). Methods Echocardiographic characteristics were analysed in 17 patients with NVM and compared with those in 10 patients with hypertensive left ventricular myocardial hypertrophy. Results Echocardiographic findings of NVM included; 1)A two layer structure at the area of NVM was seen, with a compacted thin epicardial band and a much thick non-compacted endocardial layer consisted: of prominent trabeculations and multiple deep intertrabecular recesses. NVM was diagnosed when a maximal end systolic ratio of non-compacted to compacted layers more than > 2. 2)The areas of NVM were often at apex, mid-lateral wall, and mid-inferior wall in left ventricle and at apex, mid-lateral wall in right ventricle. Regional hypokinesia of both the NVM segments and the compacted segments resulted in a decreased global ventricular function. 3) Direct blood flow from the ventricular cavity into the intertrabecular recesses throughout the cardiac cycle was shown on color Dopplor imaging. Conclusion Specific characteristics of NVM can be demonstrated on echocardingmphy,which is the first line and best method for diagnosing NVM.