超声心动图诊断左室心肌致密化不全

Diagnosis of noncompaction of left ventricular myocardimn with echocardiography

目的探讨左室心肌致密化不全的彩色多普勒超声心动图表现。方法采用超声心动图常规测量各腔室内径及心功能主要参数,分析二维、CDFI及频谱多普勒特点。结果左室心肌致密化不全的主要超声表现为:左室中下段心内膜面内见多发突起的肌小梁,呈网络样交织,心内膜节段性缺失;突起的肌小梁间见深陷的隐窝;CDFI显示隐窝内色彩暗淡的血流与心腔内高速血流相通;病变区域致密心肌变薄,运动明显减弱;左房室增大,左室舒张末期内径(61±6)mm,左室射血分数(LVEF)为(36±15)%。结论左室心肌致密化不全具有特征性的超声改变,彩色多普勒超声心动图是无创、敏感诊断心肌致密化不全的首选方法。

Objective To discuss the characteristics of color Doppler echocardiography of noncompaction of left ventricular myocardium（NVM） for differential diagnosis. Methods The diameter of the chambers and the main indicators of cardiac function were measured in the long - axis and short - axis view of the left ventricle, apical four - chamber view. Two - dimensional, color and spectral Doppler characteristics were analyzed. Results The main characteristics of NVM were that there were many muscular trabeculations with deep intertrabecular recesses as network - like on the endocardium of apical and mid - segment of left ventricle. Segmental absence of the endocardium was observed. The color Doppler flow imaging showed that blood in the muscular trabeculations tissues may circulate to chambers of the heart. Left ventricular and atrial hypertrophy, thinner myocardium with weak motion were observed. Left ventricular end diastolic diameter was （61 ± 6） mm, left ventricular ejection fraction （EF）was 36% ± 15%. Conclusion The ultrasonic changes of NVM was characteristic and the color Doppler echocardiography can be used as the first choice examination method for the diagnosis of NVM.