二尖瓣腱索断裂彩色多普勒超声心动图特征及规律性研究

侯传举; 邓东安; 朱鲜阳; 韩秀敏; 杨军; 李春华

中国临床医学影像杂志 ›› 2007, Vol. 18 ›› Issue (11) : 768-770.

论著

二尖瓣腱索断裂彩色多普勒超声心动图特征及规律性研究

侯传举1，邓东安1，朱鲜阳1，韩秀敏1，杨军2，李春华2

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Study on characteristics and regularity of ruptured mitral chordae tendineae in color Doppler echocardiography

HOU Chuan-ju1, DENG Dong-an1, ZHU Xian-yang1, HAN Xiu-min1, YANG Jun2, LI Chun-hua2

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摘要

目的：探寻二尖瓣腱索断裂（RMCT）彩色多普勒超声心动图（CDE）特征及规律性。方法：应用CDE检查30例RMCT，寻找CDE特征和规律性，7例心血管造影对照，所有病例均经手术证实。结果：根据CDE图像特征表现对所有RMCT及合并畸形全部做出正确诊断。RMCT的CDE特征和规律性：①二维超声心动图（2DE）显示断裂的二尖瓣腱索呈“梿枷样”改变，称2DE“梿枷征”。②M型超声显示二尖瓣曲线附加线性回声。③合并二尖瓣脱垂患者，M型超声同时显示脱垂的二尖瓣叶呈“吊床样”改变，2DE于收缩期显示脱垂的二尖瓣叶凸向左心房内。④脉冲多普勒和连续多普勒在二尖瓣口可记录到收缩期湍流频谱。⑤彩色多普勒血流显像于收缩期显示过二尖瓣五彩镶嵌反流束血流信号。⑥RMCT男性明显多于女性，部分断裂明显多于完全断裂。结论：RMCT的CDE特征及规律性明显，CDE对RMCT有特异性诊断价值，但需与二尖瓣脱垂和二尖瓣赘生物鉴别诊断。

Abstract

Objective: To probe into the imaging character and regularity of ruptured mitral chordae tendineae(RMCT) in color Doppler echocardiography(CDE). Methods: Thirty patients of RMCT were examined with CDE. Seven cases underwent angiocardiography. All cases were confirmed by operation. Results: Thirty cases were accurately diagnosed by imaging character of CDE. The features of CDE in RMCT: ①The ruptured chordae tendineae of mitral valve seems like flail on 2DE, named 2DE “flail sign”. ②M-mode echocardiography showed superimposed curve echo and trembling wave of mitral valve. ③For patients with mitral valve prolapse, a hammock-like prolapsed mitral valve can be seen on M-mode echocardiography and the prolapsed mitral valve protrude into left atrial on 2DE during systole. ④Pulse Doppler and continuous Doppler could record turbulent flow spectra from left atrial on top of mitral valve during systole. ⑤Color regurgitation flow through the mitral valve could be observed on CDFI during systole. ⑥The incidence rate of RMCT is much higher in male than in female and partial rupture accounts for larger proportion than complete rupture. Conclusions: The feature of CDE image in RMCT was obvious. CDE was valuable in diagnosing RMCT, but it should be differented from mitral valve prolapse and mitral valve vegetation.

导出引用

侯传举;邓东安;朱鲜阳;韩秀敏;杨军;李春华. 二尖瓣腱索断裂彩色多普勒超声心动图特征及规律性研究[J]. 中国临床医学影像杂志. 2007, 18(11): 768-770

HOU Chuan-ju;DENG Dong-an;ZHU Xian-yang;HAN Xiu-min;YANG Jun;LI Chun-hua. Study on characteristics and regularity of ruptured mitral chordae tendineae in color Doppler echocardiography[J]. Journal of China Clinic Medical Imaging. 2007, 18(11): 768-770

中图分类号： Ｒ542.51 Ｒ540.45