先天性双孔二尖瓣畸形的彩色多普勒超声心动图诊断

Color Doppler echocardiographic diagnosis of double-orifice mitral valve

目的通过总结分析先天性双孔二尖瓣畸形(DOMV)的超声表现,探讨彩色多普勒超声心动图的诊断价值。方法分别对7例先天性双孔二尖瓣畸形进行常规心脏检查,重点观察二尖瓣短轴切面、心尖四腔和两腔切面及胸骨旁左室长轴切面,观察瓣口形态、瓣膜回声、血流动力学情况及有无合并其他心血管畸形,并与手术比较。结果7例患者完全型2例,不完全型5例。二尖瓣中-重度反流2例,轻-中度反流3例,轻度狭窄伴轻度反流1例,无狭窄及反流1例。伴乳头肌发育异常1例,伴主动脉瓣二叶瓣畸形合并主动脉瓣赘生物形成1例。3例经手术证实。结论彩色多普勒超声心动图可以准确诊断先天性双孔二尖瓣畸形,并了解其血流动力学改变,是临床诊断的首选方法。

Objective To discuss the clinical value of color Doppler echocardiography in diagnosing double-orifice mitral valve （DOMV）. Methods Seven consecutive patients were examined. The changes of the morphology and flow dynamics of DOMV were studied, and other congenital cardiac abnormalities were also observed. These results were compared with those of surgery. Results The seven cases of DOMV were diagnosed by echocardiography, and the surgical therapy was performed in three cases. The diagnosis of color Doppler echocardiography were confirmed by surgery. A complete bridge type was found in two cases, an incomplete bridge type in five, while mitral regurgitation （MR） was detected in five cases, MR and mitral stenosis （MS） in one, and no MR and MS in one. One accompanied with papillary muscles abnormality, and one with bicuspid aortic valve. Conclusion Color Doppler echocardiography offers a simple, useful and reliable technique in diagnosing DOMV.