CAJ | 학술논문

目的探寻两腔心(BH)及合并畸形的彩色多普勒超声心动图图像特征.方法超声检查20例BH,寻找BH及合并畸形的声像图特征表现.所有患者均有心血管造影对照,14例经手术证实.结果根据声像图特征表现对19例作出正确诊断,1例误诊为二尖瓣闭锁.BH及合并畸形的声像图特征明显:①二维超声心动图(2DE)心尖四腔观显示房间隔与室间隔回声全部失落,心内十字交叉消失,收缩期显示一组共同房室瓣关闭,呈"8字形"改变,称2DE"8"字征;舒张期一组共同房室瓣开向一个共同心室腔.②彩色多普勒血流显像(CDFI)舒张期均显示共同心房内血流信号通过共同房室瓣进入共同心室内;收缩期显示过共同房室瓣五彩镶嵌反流束血流信号15例.③在20例BH中,心房正位16例,心房反位4例.共同心室A型10例,B型2例,C型8例.大动脉位置关系Ⅰ型4例,Ⅱ型7例,Ⅲ型9例.肺动脉狭窄18例,肺动脉高压2例.④合并肺动脉狭窄患者CDFI于收缩期显示过肺动脉五彩镶嵌射流束血流信号.结论 BH及合并畸形的声像图特征明显,其对BH及合并畸形有特异性诊断价值.
목적 탐심량강심(BH)급합병기형적채색다보륵초성심동도도상특정.방법 초성검사20례BH,심조BH급합병기형적성상도특정표현.소유환자균유심혈관조영대조,14례경수술증실.결과 근거성상도특정표현대19례작출정학진단,1례오진위이첨판폐쇄.BH급합병기형적성상도특정명현:①이유초성심동도(2DE)심첨사강관현시방간격여실간격회성전부실락,심내십자교차소실,수축기현시일조공동방실판관폐,정"8자형"개변,칭2DE"8"자정;서장기일조공동방실판개향일개공동심실강.②채색다보륵혈류현상(CDFI)서장기균현시공동심방내혈류신호통과공동방실판진입공동심실내;수축기현시과공동방실판오채양감반류속혈류신호15례.③재20례BH중,심방정위16례,심방반위4례.공동심실A형10례,B형2례,C형8례.대동맥위치관계Ⅰ형4례,Ⅱ형7례,Ⅲ형9례.폐동맥협착18례,폐동맥고압2례.④합병폐동맥협착환자CDFI우수축기현시과폐동맥오채양감사류속혈류신호.결론 BH급합병기형적성상도특정명현,기대BH급합병기형유특이성진단개치.
Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.