二尖瓣腱索断裂的彩色多普勒超声心动图诊断

Diagnosis of Rupture of Mitral Chordae Tendinese by Color Doppler Echocardiogrphy

应用彩色多普勒超声心动图（ＣＤＥ）在已手术的６０１６例各种心血管疾病中检出５例二尖瓣腱索断裂（ＲＭＣＴ），ＣＤＥ诊断准确率１００％。本病的ＣＤＥ表现是两维超声心动图（２ＤＥ）显示腱索断裂的二尖瓣叶呈“枷样”或“甩鞭样”改变，彩色多普勒（ＣＤ）显示收缩期过二尖瓣五彩相间返流束血流信号。结果表明ＣＤＥ对本病有特异性诊断价值，可代替心血管造影检查。ＣＤＥ诊断本病需与二尖瓣脱垂（ＭＶＰ）和二尖瓣叶赘生物（ＭＶＶ）相鉴别。一旦确诊应及早手术治疗。

In 6016 patients of different cardiovascular diseases operated,5 cases with rupture of mitral chordae tendineae (RMCT) were detected by color Doppler echocardiography(CDE).The accuracy rate of CDE was 100%. The ultrasonic manifestations of RMCT in CDE were 'flail shape'change of the mitral leanets with ruptued chordae tendineae in two-dimensional echocardiography (2DE) and a shade of multi-colored resurgitated jet of blood through mitral valve during systol in CDE.It is concluded that CDE has specific value in the diagnosis of RMCT and can replace the angiocardiography. It is necessary to differentiate RMCT from mitral valve prolapse(MVP) and mitral valve vegetation(MVV)by CDE. Surgical treatment should be done as soon as the diagnosis of RMCT is confirmed.