心肌致密化不全超声心动图的特征分析

Analysis of noncompaction of the ventricular myocardium by echocardiography

目的:通过超声心动图观察心肌致密化不全(NVM),了解NVM超声心动图的特征性表现。方法:对我院2005年4月～2007年12月31例确诊为NVM患者的超声心动图诊断结果进行回顾总结。结果:31例NVM有家族史发病7例(22.6%),无家族史发病24例(77.4%);左心室病变21例(67.7%),右心室病变2例(6.5%),双心室病变8例(25.8%);病变心室扩大31例(100%);左室射血分数<55%29例(93.5%);常见受累部位依次为左室的心尖水平29例(93.5%),乳头肌水平26例(83.9%),腱索水平6例(19.4%),瓣口水平1例(3%)。受累室壁收缩末期非致密化心肌层与致密化心肌层的比值为2.2～3.1,31例NVM患者彩色多普勒均显示NVM的隐窝内暗淡血流充填。结论:NVM的临床表现各异,较难确诊,而NVM的超声心动图特征明显,因此NVM超声心动图具有特异性表现。

Objective： To observe characteristic presentation of noncompaction of the ventricular myocardium （NVM） by echocardiography. Methods： Echocardiographic images of 31 patients in our hospital who were definitely diagnosed as NVM were reviewed retrospectively from April 2005 to December 2007. Results： Family history was observed in 7 cases of 31 patients（22.6%）, but was not observed in 24 cases（77.4%）. Twenty-one cases had lesion impaired in left ventricle（67.7%）, 2 cases had lesion in fight ventricle （6.5%） and 8 cases in both ventricles （25.8%）. Furthermore, involved ventricles in 31 cases （100%） were enlarged and ejection fraction of left ventricle in 29 cases （93.5%） were less than 55%. The most impaired areas in sequence were left ventricle apex in 29 cases（93.5%）, papillary muscles in 26 cases（83.9%）, chorda tendineaes in 6 cases （19.4%） and valve level in 1 ease（3%）. Ratios of the impaired ventricular wall thickness between the noncompacted trabeeulated layer and the nontrabeculated compacted layer were from 2.2 to 3.1. And 31 cases （100%） indicated color Doppler blood flowing into intertrabecular recesses with dim blood in them and blood filling defect in trabecular muscles. Conclusions： NVM was difficult to diagnose definitely because of its various kinds of clinical manifestations. But echocardiographic images of NVM were characteristic, so echoeardiography could be an excellent tool to diagnose NVM.