风心病二尖瓣病变声像图定量及病理改变研究

A Study of UItrasonographic Quantitative and Pathological Observing in Rheumatic Mitral Valve Disease

用自制“DFY—1型超声图像定量分析诊断仪”对病变组14例风湿性心脏病二尖瓣病变患者的二尖瓣行经胸声像图定量,测量其最大、最小、平均灰阶(GS)、分贝(dB)值,并与正常组36例对比,进行统计学分析.全部14例均行二尖瓣置换术后二尖瓣组织病理检查.术前经胸取二维超声心动图左室长轴切面检测二尖瓣前叶声像图定量,其平均测值病变组为:GS15.57±5.33、dB65.95±8.67;正常组为:GS 7.03±4.75、dB41.93±16.28,有显著统计学差异(P均<0.01).并进行了术后二尖瓣组织声像图定量.病理检查:大体观察,所有病变瓣膜均有不同程度的增厚、变硬等改变;镜下显示有程度不同的血管内壁增生、纤维结缔组织增生、软骨样变、胶原纤维变性、玻璃样变、钙化等改变.这些因素均可导致回声增强且呈不均匀性改变.结果提示,声像图定量在一定程度上有助于组织病理改变的辩别.

In 14 patients with rheumatic heart disease the transthoracic ultrasonography of mitral valve was quantitatively studied used by ultrasonographic quantitalive analysis system in type DFY-1. The ultrasonographic quantitative Parameters as the maximum and minimum of echo, mean grey steps (GS) and decibel (dB) were measured, and these values were compared with the measured value in 36 normal individuals. The pathologic study of mitral was done in all 14 cases after operator of mitral valve replaced. At the anterior mitral ieaflet in rheumatic group GS (15. 57±5. 33 vs 7. 03±4. 75 P<0. 01) and dB (65. 95±8. 67 vs 41. 93±16. 28 P<0. 01) were significantly higher than those in normal group. Pathologic observing showed that all rheumatic valves thicken and harden in varied degree. Under mi-crosocopy wall of blood vessel, fiber and connective tissue hyperplasia, cartilage like changes, glass like changes and calcification. The samples of rheumatic valve were quantitative measured in ultrasonography. The GS and dB were significantly higher than those in normol. All pathologic changes induced echo increace and evenless. It is suggested that ultrasonographic quantitative relation with tissae pathol-ogy and may be contribute to distinguish type of pathologic change in some degree.