超声心动图对室间隔缺损合并主动脉瓣脱垂的诊断和鉴别

目的　分析室间隔缺损 (VSD)合并主动脉瓣脱垂 (AVP)的超声心动图特征和与主动脉窦瘤的鉴别。方法　 18例VSD合并AVP患者进行二维超声心动图 ( 2DE)和彩色多普勒血流显像 (CDFI)检查并被手术确诊。结果　 18例VSD以干下型多见 ,其次为膜周部。超声测定VSD大小与手术相符者 6例 ,略小于手术 7例 ,大于手术 5例。AVP中右冠瓣 16例 ;无冠瓣 2例超声漏诊。脱垂的主动脉瓣不同程度突入VSD并部分或完全遮挡VSD ,当AVP明显时 ,超声表现为瓣叶延长、变形、移位 ,瓣体呈“瘤样”经VSD口突入右室。结论　超声心动图可评价主动脉瓣病变程度 ,对外科手术修复VSD和AVP提供有价值的信息

Echocardiography diagnosis and differential diagnosis of VSD associated with aortic valve prolapse

Objective To evaluate the ultrasound findings of VSD associated with aortic valve prolapse (AVP),and to study it's differential diagnosis from aneurysm of aortic sinus.Methods 18 cases of VSD associated with AVP were examined by 2-DE and CDFI.All cases were confirmed by operation.Results Among 18 cases of VSD,most of them were below branch septum defect,and the secondary were membrane-surrounding septum defect.Comparing the ultrasound measurements of defect with the findings in operation,we found that 6 cases were equal,7 cases were smaller,5 cases were larger,Among the AVP,16 cases had right coronary valve prolapse.2 cases which had non-coronary valve prolapse were miss-diagnosed by ultrasound.The prolapased aortic valve protruded into VSD in different degree and partly or completely covered VSD.In serious AVP cases,aortic valve which was prolonged,deformed and displaced and aneurysmal valve that protruded into right ventricle via VSD were often found in ultrasound. Conclusion Echocardiography is useful in assessing the degree of VSD combined with AVP,and it can provide valuable information to surgery.