超声心动图及标准化心肌分段法在心肌致密化不全诊断中的应用

目的 探讨超声心动图和标准化心肌分段法在心肌致密化不全诊断中的应用价值.方法 选择2000年8月至2008年8月经我院诊断的心肌致密化不全患者9例,男6例,女3例,年龄2～73岁,总结心肌致密化不全患者的超声心动图特征,并引用美国心脏协会建议的标准化心肌分段法,分析患者病变区域的分布特点.结果 9例患者的超声心动图均显示受累室壁由疏松的肌小梁和其间的深隐窝构成,隐窝内血流与心室腔相通.根据标准化心肌分段法,心尖顶段和心尖段下壁受累9例,心尖段侧壁和中部-心腔段下壁受累7例,中部-心腔段侧壁受累6例.心尖段和中部-心腔段室间隔、基底段下壁和侧壁及右心室心尖部受累均为1例.左心室前壁无受累.结论 超声心动图结合标准化心肌分段法对诊断心肌致密化不全具有重要价值,心尖顶段受累是超声诊断本病敏感而重要的依据之一.

Echocardiographic standardized myocardial segmentation features in patients with left ventricular noncompaction

Objective To analyze the echocardiographic standardized myocardial segmentation features in patients with left ventricular noncompaction ( LVNC ). Methods Echocardiographic characteristics of 9 patients with LVNC were analyzed and the localization of lesions were determined according to the standardized myocardial segmentation (SMS) recommended by American Heart Association (AHA). Results Loose trabeculation in the myocardial lesions were evidenced in all LVNC patients. Communication between deep intertrabecular recess and LV cavity was evident with color flow imaging. According to SMS of AHA, noncompaction of ventricular myocardium was localized in apical segment in all 9 patients, in apical segment of the inferior wall (IW) in 9 patients, in apical segment of the lateral wall (LW) in 7 patients, in middle segment (MS) of IW in 7 patients, in MS of LW in 6 patients. One NC segment was also evidenced in apical segment and MS of septal ventricular wall, basal segment of IW and LW and right ventricular apex, respectively. NC was not found in left ventricular anterior wall. Conclusion Echocardiographic standardized myocardial segmentation is helpful to diagnose LVNC and NC was mostly localized in the apical segments of LVNC patients.