摘要
目的评价实时三维经胸超声心动图在诊断二尖瓣脱垂中的临床应用价值。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%,诊断二尖瓣脱垂病理改变的准确率为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,在诊断二尖瓣脱垂中具有重要的临床价值。
Objective To evaluate the value of real-time three dimensional transthoracic echocardiography in diagnosing mitral valve prolapse. Methods Thirty-four patients with mitral valve prolapse with moderate mitral regurgitation were examined by real-time three dimensional transthoracic echocardiography preoperatively. The categories of mitral pathological change and compartmental localization were judged and recorded,and were compared with surgical findings. Carpentier＇s nomenclature was applied to the mitral valve anatomic localization of real-time three dimensional echocardiography and surgery. Three anterior leaflet scallops were defined as A1,A2 and A3,and 3 posterior leaflet scallops were defined as P1,P2 and P3. The surgeons recorded the pathology of mitral valve prolapse,ruptured chordae,and the location of scallop lesions in each leaflet scallop. Results The shape and spatial structure of the anterior and posterior leaflets was clearly displayed using real-time three dimensional transthoracic echocardiography,and the mitral valve and its chordae tendineae were observed through left atrium view and left ventricular view. Compared with surgery findings,the accuracy rate of real-time three dimensional transthoracic echocardiography in diagnosing mitral valve prolapse was 100% qualitatively,94.1%（32/34） in diagnosing the categories of mitral pathological change,and 91.2% （31/34） in localizing the diseased region with the anterior and posterior mitral valve. Conclusion Real-time three dimensional transthoracic echocardiography can clearly display the pathological shape of the mitral valve prolapse,accurately localize the diseased region,and provide reliable evidence to design surgical procedure plans. It has essential value in diagnosing mitral valve prolapse.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2010年第12期1332-1335,共4页
Journal of Third Military Medical University
基金
第三军医大学临床科研创新基金(2008XG14)~~
关键词
超声心动描记术
三维
二尖瓣脱垂
定位
诊断
echocardiography
three-dimensional
mitral valve prolapse
localization
diagnosis
