四维超声心动图评价二尖瓣脱垂

Evaluation of mitral valve prolapse by four dimensional echocardiography

采用经胸壁与经食管检查途径获取二维数据，对１０例正常人及２０例二尖瓣脱垂患者的二尖瓣装置及返流束进行了四维（动态三维）超声心动图重建。结果显示，正常二尖瓣装置呈＂马鞍＂形结构，瓣膜附着于瓣环前后缘处靠近左房，位置较高，内外侧结合部附着处靠近左室，位置较低。收缩期二尖瓣前后叶对合良好，四维超声心动图可从左房、左室侧及四腔切面等多个方位显示二尖辩脱垂病变的立体结构关系，脱垂部位、形状、程度及活动情况均可清晰显示，并可对返流束进行四维重建，显示其立体形态及动态变化。对全面理解二尖瓣脱垂的病理改变、提高诊断率、协助制定治疗方案及评价疗效有重要价值。

To understand the stereoscopic structure and the motion of mitral valve prolapse,the four-dimensional(i.e. dynamic three-dimensional) echocardiography of mitral valve apparatus and its regurgitant jet were reconstructed in 10 normal and 20 patients with mitral valve prolapse by use of transthracic and transesophageal echocardiography. The results indicate that the normal mitral valve apparatus is a consistant saddle-shaped configuration with its anterior and posterior high points located near aortic root and posterior left ventricular wall, respectively, and its low points located medially and laterally. In systole,both anterior and posterior leaflets are closed tightly. The spatial relationship of mitral leaflets and annulus can be observed on the bird-view of fourdimensional images of mitral valve to see from left ventricule to left atrium or from left atrium to left ventricule,on which the position,shape,severity and motion of the part of prolapsed valve were displayed clearly. We also obtained the four-dimensional images of regurgitant blood flow which appeared as a column and its transversal area,spatial position and dynamic change, This study demonstrated that four-dimensional echocardiography could show the stereoscopic views and motion of mitral valve prolapseand its regurgitant jet. It is great value in understanding of mitral valve prolapse and raising the diagnostic rate and giving assistant to make therapy decision and evalute operative results.