超声心动图诊断心肌致密化不全临床诊断价值分析

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1、超声心动图诊断心肌致密化不全临床诊断价值分析【摘要】目的探讨超声心动图对心肌致密化不全(NVM)的诊断价值，提高对左室心肌致密化不全的诊断率，以预防致死性心律失常和栓塞。方法对48例左心室心肌致密化不全患者的超声心动图进行分析总结,参照超声诊断标准，彩色多普勒超声以左心室长轴、左心室短轴、心尖四腔等切面扫查，重点观察近心尖1/3的心肌与心内膜。结果48例患者的超声心动图均冇典型特征：左心室内或单一右心室或双心室内可见多发异常粗大肌小梁，呈网状、蜂窝状，肌小梁间见大小不等的深陷间隙，病变部位以近心尖1/3室壁最为明显，偶见累及基底段下壁心室壁，48例患者中发现1例累及基底段下后壁心室壁，病变

2、部位以左室前壁、侧壁、后壁及右心室的心尖部、游离壁为主，48例左室型31例，右室型2例，双心室型15例。彩色多普勒血流显像显示隐窝内低速血流与心腔内高速血流相通，受累心室增大，左心室心肌收缩及舒张功能减低。48例中40例有不同程度二尖瓣反流及三尖瓣或主动脉瓣反流，2例合并动脉导管未闭(均手术)，2例伴有隐窝内血栓的形成。结论彩色多普勒超声心动图可在无症状的早期萌发阶段就可发现心肌结构异常、功能无明显异常的特征性病变，进行冇针对性和预防性的干预，多能明显延长患者的生存时限和生存质量；NVM有典型的超声心动图特征性表现，超声心动图是诊断NVM的最住选择。【关键词】心肌致密化不全；超声心动图；彩

3、色多普勒；诊断[Abstract1ObjectiveToinvestigatediagnosisvalueofultrasoniccardiogramfornoncompactionofreticularmyocardium(NVM),andtoimprovediagnosisrateofleftventricularnoncompaction，inordertopreventfatalarrhythmiaandembolism.MethodsAnalysisandsummarizationweremadeonultrasoniccardiogramin48patientswithleft

4、ventricularnoncompaction,accordingtoultrasounddiagnosiscriteria.ColorDopplerultrasoundprovidedsearmingonsectionsofleftventricularlongaxis,leftventricularshortaxis,andapicalfour-chamber,especiallyonmyocardiumandendocardiumin1/3nearapexcordis・ResultsAllthe48caseshadtypicalcharacteristicsofultrasonic

5、cardiogram,asmultiplethicktrabecularwithformsofnetorhoneycombinsideleftventricle,singlerightventricleorbothventricles.Deepgapsofvarioussizeremainedbetweentrabecular.Obviouslesionsoccurredinventricularwallin1/3nearapexcordis,withrarelyinvolvedbasalsegmentinferiorventricularwall.Therewas1caseamongth

6、e48caseswithinvolvedbasalsegmentinferior-posteriorventricularwall.Lesionsmainlyoccurredinleftventricularanteriorandsidewa11,foilowedbyposteriorwall,andapexcordisandfreewallinrightventricle・Amongthe48cases,therewere31casesofleftventricletype,2casesofrightventricletype,and15casesofbothventridestype.

7、ColorDopplerf1owimagingshowedconnectionbetweenlow-velocityflowinrecessandhigh-velocityflowincardiacchamber,enlargedinvolvedventricle,andreducedsystolicanddiastolicfunctionin1eftventricularmyocardium.Therewere40ca