成人房间隔膨出瘤及合并畸形彩色多普勒超声心动图特征和规律性研究

目的:探寻成人房间隔膨出瘤(IASA)及合并畸形彩色多普勒超声心动图(CDE)的特征和规律性.材料和方法:应用CDE检查38例成人IASA及合并畸形,在经胸超声心动图检查之后22例又行经食管超声心动图检查,26例行心导管检查,20例行房间隔缺损(ASD)封堵术,8例行合并畸形手术治疗.结果:根据CDE特征对38例成人IASA及合并畸形全部做出正确诊断.成人IASA及合并畸形CDE特征和规律性明显:①在二维超声心动图(2DE)心尖四腔心切面、胸骨旁四腔心切面和剑下四腔心切面显示房间隔中部变薄,局部凸向右心房,并随心动周期摆动.② IASA合并畸形者多见(94.7%),孤立性IASA少见(5.3%).在合并的畸形中ASD多见(80.0%),其次是室间隔缺损(5.3%)和房间隔卵圆孔未闭(5.3%),还有主动脉瓣狭窄和主动脉窦瘤破裂等,但少见.③孤立性IASA患者2DE显示各心腔内径正常;合并ASD患者2DE显示右心房、右心室内径增大,彩色多普勒血流显像(CDFI)显示过房间隔左向右五彩镶嵌分流束血流信号;合并室间隔缺损2DE显示左心房内径增大,CDFI显示过室间隔左向右五彩镶嵌分流束血流信号.④经胸超声心动图很难准确显示IASA合并ASD的数目、大小和位置;经食管超声心动图可准确显示IASA合并ASD的数目、大小和位置.结论:CDE对成人IASA及合并畸形有特异性诊断价值.应用CDE明确判断合并畸形比诊断IASA更重要;应用经食管超声心动图诊断合并畸形ASD比经胸超声心动图更具有临床价值.

Study on Characteristics and Regularity of Color Doppler Echocardiography on Adult Interatral Septal Aneurysm and Deformity

Purpose To probe into the imaging characteristics and regularity of adult interatrial septal aneurysm(IASA) and deformity in color Doppler echocardiography(CDE).Materials and Methods Thirty-eight patients of adult IASA cases were examined by CDE.After transthoracic echocardiography,22 cases were examined by transesophageal echocardiography,26 cases were examined by cardiac catheterization,20 cases were operated by transcatheter closure of atrial septal defect(ASD),8 cases were treated by deformity operation...