超声心动图对心肌致密化不全的诊断及临床意义探讨

目的:探讨超声心动图对心肌致密化不全的诊断及临床意义。方法:应用Vivid7、HP5500彩色多普勒超声诊断仪(探头频率为2～4MHz)对32例左室心肌致密化不全患者进行检查,采用二维、M型、彩色及频谱多普勒观察病变心肌及心内膜改变,重点观察心尖段。常规测量各腔室内径、左室壁正常段心肌厚度及动度,评价心室舒张功能、计算左心室射血分数EF及瓣膜反流等基本信息。结果:①受累的心室内膜面可见多发异常粗大的、呈蜂窝状的肌小梁和交错深陷的隐窝形成网状结构。②病变区域心室壁外层的致密心肌明显变薄,为中低回声,较正常心肌薄2~4mm,其心肌厚度<6mm,而内层心肌疏松增厚为强回声。③病变以近心尖部1/3室壁节段最为明显,很少累及室间隔及基底段室壁。④彩色多普勒可示隐窝间隙之间有低速血流与心腔相通。⑤多数患者以渐进性的心功能不全、呼吸困难、体循环栓塞、心律失常为主要表现,本组患者临床表现为心力衰竭22例,心脏杂音3例,心律失常2例,5例无明显不适症状。结论:超声心动图检查是准确、无创诊断心肌致密化不全的首选方法,能够对房室结构和心功能进行全面评价,有助于明确心力衰竭病因并协助治疗,同时也有助于筛查心肌致密化不全家族,对临床治疗起着很好的指导作用。

Application of Echocardiography in Diagnosis of Noncompaction ofVentricular Myocardium and Its Clinical Significance

Objective:To explore the clinical value of echocardiography in diagnosing non-compaction ventricular myocardium(NVM).Methods:A total of thirty-two patients with NVM were included in this study.The changes of myocardial and endocardial lesion in left ventricle,especially in apex,were observed by 2-dimensional,M-type,color doppler and spectrum doppler echocardiography by GE vivid7 and HP 5500 ultrasonic diagnositic system.Internal diameters of each cavity and thickness/movement of normal myocardium of the lef...