实时三维超声心动图评价二尖瓣裂的初步研究

Assessment of mitral valvular cleft by real time three-dimensional echocardiography

目的探讨实时三维超声心动图观察二尖瓣裂的价值。方法应用实时三维超声成像新技术观察13例二尖瓣前叶裂患者,其中单纯二尖瓣裂3例,合并部分型房室间隔缺损10例,全面显示二尖瓣裂的整体形态,并应用彩色三维血流模式观察二尖瓣反流的空间走行及方向。结果实时三维超声心动图能从多方位全面观察显示二尖瓣裂部位、程度、瓣裂方向,10例并发于部分房室间隔缺损的二尖瓣裂均为前瓣中部完全性裂,瓣裂指向室间隔方向。3例单纯二尖瓣裂者中2例为前瓣近外侧连合处完全性裂,1例为前瓣中部完全性裂,3例瓣裂均指向主动脉瓣方向。结论单纯二尖瓣裂与部分型房室间隔缺损的二尖瓣裂从二尖瓣发育上存在根本性的不同,实时三维超声心动图能完整显示二尖瓣裂的整体形态,较二维超声心动图能提供更为全面、客观的诊断和治疗依据。

Objective To explore the value of real-time three-dimensional echocardiography （RT-3DE） in the assessment of cleft mitral valve. Methods Thirteen patients with cleft mitral valve were examined by RT-3DE, among which 3 cases had isolated clefts, 10 cases had complicated atrioventricular septal defects. Results Morphologically, clefts in 3 cases of isolated cleft mitral valve pointed toward the left ventricular outflow tract, while in 10 cases of atrioventricular septal defects where the clefts directed toward the ventricular inlet septum. RT-3DE produced novel views of mitral valve clefts. Conclusion Isolated mitral valve clefts were totally different from those in atrioventricular defect in terms of embryonic development. RT- 3DE permitted comprehensive 3D viewing of the cleft in the mitral valve which was impossible by 2D echocardiography.