关键词超声心动图描记术;实时三维;二尖瓣脱垂;定位

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1、实时三维经胸超声心动图在诊断二尖瓣脱垂中的应用价值郭燕丽1王海东2杨康2王文婷1申斌1郭爱民1（第三军医大学：1西南医院超声科，2西南医院心外科，重庆400038）摘要目的：探讨实时三维经胸超声心动图在诊断二尖瓣脱垂中的临床价值。方法：34例二尖瓣脱垂伴中度以上反流患者，术前行实时三维经胸超声心动图检查，判断并记录二尖瓣瓣膜病变类型和小叶分区定位，并与外科手术对照。实时三维超声心动图和外科手术中二尖瓣的解剖定位均采用Carpentier命名法，将前叶分为A1、A2和A3，后叶分为P1、P2和P3。所有患者在行实时三维经胸超声心动图1周内行外科手术，由外科医师记录

2、二尖瓣脱垂、腱索断裂等病理类型及二尖瓣小叶具体的病变部位。结果：实时三维经胸超声心动图能清晰地显示二尖瓣的前叶和后叶的形态和空间结构，并能分别从左房面和左室面观测二尖瓣及其腱索。与外科手术相对照，实时三维经胸超声心动图定性诊断二尖瓣脱垂的准确率为100%，诊断二尖瓣脱垂病因的准确率为94.1%（32/34），定位诊断二尖瓣前、后叶病变区域的准确率为91.2%(31/34)。结论：实时三维经胸超声心动图能清晰显示脱垂二尖瓣的病理形态，并对二尖瓣瓣叶进行准确分区和定位病变区域，为外科手术方式的制定提供可靠的依据，在诊断二尖瓣脱垂中具有重要的临床价值。关键词：超声心动

3、图描记术；实时三维；二尖瓣脱垂；定位Thevalueofreal-timethreedimensionaltransthoracicechocardiographyindiagnosingmitralvalveprolapseGUOYan-li1,WANGHai-dong2,YANGKang2,WANGWen-ting1,SHENBin1,GUOAi-ming11DepartmentofUtrasound,2DepartmentofCardialandThoracicSurgery,SouthwestHospital,theThirdMilitaryMedica

4、lUniversity,Chongqing,China，40038Abstract:ObjectiveToevaluatethevalueofreal-timethreedimensionaltransthoracicechocardiographyindiagnosingmitralvalveprolapse.MethodsThirtyfourpatientswithmitralvalveprolapsewithmoderatemitralregurgitationwereexaminedbyreal-timethreedimensionaltransthor

5、acicechocardiographypreoperatively.Thecategoriesofmitralpathologicalchangeandcompartmentallocalizationwerejudgedandrecordedcomparingwithsurgicalfindings.Carpentier’snomenclaturewasappliedtothemitralvalveanatomiclocalizationofreal-timethreedimensionalechocardiographyandsurgery.Threean

6、teriorleafletscallopsweredefinedasA1,A2andA3,andthreeposteriorleafletscallopsweredefinedasP1,P2andP3.Thesurgeonsrecordedthepathologyofmitralvalveprolapseandrupturedchordae,andthelocationofscalloplesionsineacheafletscallop.ResultsTheshapeandspatialstructureoftheanteriorandposteriorlea

7、fletswasclearlydisplayedusingreal-timethreedimensionaltransthoracicechocardiography,andthemitralvalveanditschordaetendineaewereobservedthroughleftatriumviewandleftventricularview.Comparedwithsurgeryfindings,theaccuracyrateofreal-timethreedimensionaltransthoracicechocardiographyindiag

8、nosingmitral