应变率成像评价单纯性肥胖儿童左室局部心肌的收缩功能

目的:探讨应变及应变率成像在评价单纯性肥胖儿童心肌收缩功能方面的临床价值.方法:肥胖组儿童30人,年龄10±4岁,按年龄及性别匹配的健康儿童30人为对照组,分别进行二维及组织多普勒超声检查,应用应变率技术对局部心肌进行定量分析.结果:肥胖儿童左房内径增大(P<0.05),左室下壁、侧壁及室间隔心肌收缩期峰值应变、应变率明显低于正常儿童(P<0.05).结论:应变率成像技术可敏感的检测出单纯性肥胖儿童左心室心肌收缩功能及特性的改变.     

左冠状动脉起源于肺动脉的超声心动图诊断价值及漏诊分析

目的:探讨多普勒超声心动图对左冠状动脉异常起源于肺动脉(ALCAPA)的诊断价值,分析超声心动图漏诊的原因,旨在提高超声对ALCAPA诊断的准确率.方法:本文总结了17例经心血管造影及磁共振检查确诊为ALCAPA的患儿,并与其超声心动图检测结果进行对照.结果:17例患儿中,超声诊断符合11例(占64.7%),超声误诊6例(占35.3%);其中3例超声诊断为扩张型心肌病,2例超声诊断为左冠状动脉肺动脉瘘,1例诊断为二尖瓣中度反流.结论:超声心动图能较准确地诊断ALCAPA,但易漏误诊.左心室明显增大伴室间隔内丰富侧支血流信号者,应高度怀疑ALCAPA;若左冠状动脉显示不清,应行心血管造影或核磁共振检查.     

应变率成像定量评价尿毒症患者右室局部心肌舒张功能

目的:采用应变率成像技术评价尿毒症患者右室局部心肌舒张功能。方法:20例尿毒症患者,30例健康成人。采用应变率成像及组织速度成像获取心尖四腔切面右室侧壁各节段的心肌应变率及多普勒速度曲线,测量曲线上的舒张早期充盈速度(Ve)、心房收缩期充盈速度(Va)、舒张早期充盈应变率(Esr)、心房收缩期充盈应变率(Asr)。结果:尿毒症组右室侧壁基底段的Esr减低,中段Va增快,心尖段Esr减低、Va增快(P<0.05)。结论:尿毒症患者右室侧壁局部心肌存在舒张功能减退。应变率成像联合组织速度成像可检出更多舒张功能受损的右室壁节段。     

应变率成像评价2型糖尿病患者左室局部舒张功能的临床研究

目的探讨应变率成像技术评价2型糖尿病患者左室局部舒张功能的临床应用价值。方法选取左室构型正常的2型糖尿病患者30例,健康对照者30名,分别为糖尿病组和健康对照组;用应变率测量左室长轴方向18节段的心肌舒张早期峰值应变率（SRe）和舒张晚期峰值应变率（SRa）,计算SRe／SRa。比较各参数在两组之间的差异。结果糖尿病组舒张期SRe、SRa、SRe/SRa均低于健康对照组（P〈0．05）。结论应变率成像技术可以定量评价糖尿病患者的左室局部舒张心肌应变率异常,SRe、SRa、SRe／SRa可以作为评价左室局部舒张功能的有效指标。     

组织应变成像技术对儿童主动脉缩窄左心功能的评价

目的:探讨组织应变成像技术在评价儿童主动脉缩窄患者手术治疗前后左心功能的临床应用价值.方法:24例主动脉缩窄患儿于手术前后接受常规超声及组织多普勒检测,获取二尖瓣血流E/A值、左室短轴缩短率(FS)、射血分数(EF)及左室心肌的收缩期及舒张早期峰值应变和应变率.结果:①患儿手术前后E/A值、FS及EF无明显差异(P＞0.05);②患儿收缩期峰值应变术前高于术后但无明显差异(P＞0.05).③患儿术后收缩期峰值应变率略低于术前(P＞0.05),舒张早期应变率峰值高于术前(P＜0.02).结论:应变及应变率可以敏感检测主动脉缩窄儿童术后左心功能的改善.     

应变率成像评价慢性肾脏病患者左心室收缩及舒张功能的研究

目的 探讨应变率成像用于评价慢性肾脏病(CKD)患者左室收缩及舒张功能的价值.资料与方法 选取71例CKD患者(CKD3期23例,CKD4期22例,CKD5期26例),同时选取20例正常人作为对照组,利用常规超声心动图及应变率成像观察心脏结构及基底部各节段收缩、舒张早期及舒张晚期应变率指标.结果CKD患者左房内径、左室...     

Sudden infant death with anomalous origin of the left coronary artery from the pulmonary artery

Autopsy of a 2-month-old boy revealed an anomalous origin of the left coronary artery from the pulmonary trunk. The endomyocardial fibrosis associated with myocardial ischemia was noted in the left ventricular wall of the enlarged heart. Death was attributed to silent heart failure due to the anomalous left coronary artery. Significant clinical symptoms are generally observed in patients with such anomalies, however, they might cause sudden death in childhood.     

Thallium-201 imaging in anomalous left coronary artery originating from pulmonary trunk

A 3-month-old infant with anomalous origin of the left main coronary artery (LMCA) from the pulmonary trunk was evaluated using resting thallium imaging. The imaging findings were consistent with myocardial scar and ischemia of the anterolateral and posterolateral walls in the distribution of the LMCA.     

The diagnosis and assessment of an adult with anomalous origin of the left coronary artery from the pulmonary artery

Anomalous origin of the left coronary artery from the pulmonary artery (the Bland-White-Garland syndrome) is a rare congenital cardiac defect which may present for the first time in adulthood. The recognition of this disorder, which produces widespread left ventricular ischaemia and the risk of sudden death, myocardial infarction and congestive heart failure, is important as the prognosis can be improved by surgical intervention. Thallium-201 scintigraphy has a useful role in demonstrating the widespread nature of the ischaemia of the left ventricle, whilst the diagnosis is confirmed at cardiac catheterisation.     

冠状动脉起源于肺动脉的影像学研究

目的 探讨冠状动脉(简称冠脉)起源于肺动脉(ACAPA)影像学诊断方法的价值。方法 回顾性分析11例ACAPA的影像学表现。11例均行X线胸片、超声心动图(Echo)和心血管造影检查，其中1例行电子束CT(EBCT)检查。结果 10例为左冠脉起源于肺动脉，1例为右冠脉起源于肺动脉。11例胸片均未确诊，Echo诊断3例，EBCT诊断1例。心血管造影全部诊断正确，其中左冠脉异常起源者左冠脉均发自主肺动脉后窦或后壁，通过扩张的右冠脉藉侧支逆行充盈；右冠脉异常起源者右冠脉从主肺动脉右窦发出。手术与造影所见相同。3例前乳头肌缺血性纤维化，二尖瓣环扩大，前叶脱垂致二尖瓣关闭不全。结论 X线胸片诊断受限，Echo简便、无创，但操作技术及认知水平有待提高。心血管造影仍是术前确诊的“金标准”。     

Isotopic findings in anomalous origin of the left coronary artery from the pulmonary artery: report of an adult case

Anomalous origin of the left coronary artery from the main pulmonary trunk results in myocardial ischemia or infarction, and may be a cause of death in the first months of life. Some patients, however, develop satisfactory coronary collateral circulation and remain asymptomatic into adulthood. In these patients, myocardial perfusion and left ventricular function are not well understood. We report the case of a 17-yr-old female patient, suffering from anomalous origin of the left coronary artery from the main pulmonary trunk, who underwent reimplantation of the left coronary artery to the aorta. The preoperative permanent 201Tl defect of the left antero-lateral ventricular wall and the abnormal regional wall motion induced by stress exercise testing were fully reversed after the operation.