三尖瓣下移畸形的超声心动图诊断

Diagnosis of Ebstein anomaly with echocardiography

目的探讨超声心动图对三尖瓣下移畸形的诊断价值,并分析部分畸形漏诊的原因。方法回顾性分析13例经手术证实的三尖瓣下移畸形的超声心动图表现,并与手术结果进行对照。结果三尖瓣隔瓣下移4例,后瓣下移1例,隔瓣及后瓣下移6例(其中2例后瓣下移,1例部分隔瓣下移术前未发现),三个瓣均下移1例,隔瓣下移及后瓣缺如1例(后瓣缺如术前未发现);合并畸形有继发孔型房间隔缺损、卵圆孔未闭、部分型房室间隔缺损、室间隔缺损及室间隔膜部瘤等。结论超声心动图能对三尖瓣下移畸形提供较详细的形态学及血流动力学资料,但诊断中要注意排除瓣叶是否合并有畸形。

Objective To evaluate the value of echocardiography in Ebstein anomaly and analyze the misdiagnosis reason of some cases. Methods Echocardiography features were retrospectively analyzed in 13 cases of Ebstein anomaly and compared to the operation results.Results Among the 13 cases by operation, 4 of them were found with displacement in septal and 1 in posterior leaflets, 6 with displacement of both septal and posterior leaflet （ of which two displaced posterior and one partial displaced septal leaflets were not detected by echocardiography）, 1 with all 3 valves involved, and 1 with displacement of septal and absent of posterior leaflet （the later was not detected by echocardiography）. Accompanied deformations included slnall atrial septal defects, fossa ovalis opening, etc. Conclusion Echocardiography is reliable in diagnosis of Ebstein anomaly and its accompanied deformations by providing detailed morphologic and hemodynamic information if thorough scanning is performed.