中老年主动脉窦瘤破裂彩色多普勒超声心动图特征及规律性研究

 目的 探讨中老年主动脉窦瘤破裂(RASA)彩色多普勒超声心动图(CDE)特征及规律性.方法 应用CDE检查33例中老年RASA,CDE检查后3例行心血管造影对照,1例行介入封堵治疗,32例经手术证实.结果 根据CDE特征对32例成人RASA做出正确诊断,诊断准确率97.0%.中老年RASA的CDE特征及规律性明显:(1)M型超声显示左心房、左心室内径增大,室间隔、左室后壁和二尖瓣前叶运动幅度增大.(2)二维超声心动图(2 DE)胸骨旁大动脉短轴切面显示破裂的主动脉窦部向外凸出,呈"囊袋样"改变,称2 DE"囊袋征".破裂的主动脉窦瘤顶部显示大小不等的回声中断.(3)彩色多普勒血流显像(CDFI)显示过破裂的主动脉窦瘤左向右五彩镶嵌分流束血流信号,分流束血流信号基底部宽度与破口直径相仿.(4)主动脉右窦破入右心室流出道多见,主动脉右窦破入右心室和右心房次之,主动脉右窦破入右心房少见.(5)RASA合并室间隔缺损多见,合并主动脉瓣关闭不全和二尖瓣关闭不全次之.结论 中老年RASA的CDE特征及规律性明显,2 DE与CDFI结合检查对中老年RASA有特异性诊断价值.

Characteristics and regularities of rupture of aortic sinus aneurysm by color Doppler echocardiography in patients over 40 years

Objective To study the characteristics and regularities of rupture of aortic sinus aneurysm （RASA） by color Doppler echocardiography （CDE） in patients over 40 years of age. Methods Thirty-three patients with RASA were examined by CDE. Among them 3 cases underwent angiocardiography for comparison, 1 case received interventional therapy, and 32 cases were confirmed by operation. Results Thirty - two cases were accurately diagnosed by imaging characteristics of CDE, with the diagnostic accuracy rate of 97.0%. The CDE characteristics and regularity of RASA were obvious： （ 1 ） Enlarged diameters of left atrium and left ventricule and increased motion of interventricular septum,posterior wall of left ventricle and anterior mitral valve leaflet could be seen on M- mode echocardiography. （2）The parasternal short axis view of two- dimensional echocardiography （2 DE ） showed ruptured aortic sinus projected outside like a ＂sack＇, which is named 2 DE ＂saccate sign＂. The ruptured top of aortic sinus aneurysm showed echo interruption in different size. （3） Left to right color shunt flow through the rupture could be observed on color Doppler flow image （CDFI） with width of the basis of the shunt flow s＇unilar to the diameter of the rupture. （4）Rupture of the right aortic sinus into the right ventricular outflow tract was mostcommonly seen,followed by rupture of the right aortic sinus into right ventricule and right atrium. Rupture of non - coronary sinus into right atrium was rarely seen. （5） Concurrence of RASA with ventricular septal defect was most common and that with aortic insufficiency and mitral insufficiency was the second most common one. Conclusions RASA has obvious CDE characteristics and regularities. CDE is valuable in diagnosing especially RASA.