原发性心脏瓣膜黏液样变性的超声特点

Echocardiographic determination of the prevalence of primary cardiac valve myxomatous degeneration

目的通过对比超声心动图和术中病理改变，探讨原发性心脏瓣膜黏液样变性的超声特点。方法对主动脉瓣、二尖瓣及三尖瓣中度以上瓣膜反流并行心脏瓣膜手术的1080例患者的超声心动图资料及病理结果进行回顾性对比分析，以术中病理结果为金指标，分别统计二尖瓣、主动脉瓣及三尖瓣原发黏液样变的例数，分析超声诊断与病理诊断的符合率及原发心脏瓣膜黏液样变的患病率，总结超声心动图特征。结果经手术和病理证实原发性心脏瓣膜黏液样变性104例患者，患病率为9．62％。按累及瓣膜数统计共有受累瓣膜117处，超声心动图对所有黏液样变性病例均作出了血流动力学诊断（瓣膜反流，100％），对101处（86．3％）病变作出了形态学（瓣叶脱垂、瓣叶增厚、冗长）的描述，但病因提示性诊断仅2例。结论超声心动图对原发瓣膜黏液变性有特征性表现并可在术前提示原发心脏瓣膜黏液样变的可能。为术前外科治疗方案的决策提供依据。

Objective To determine the capability of echocardiography to identify primary cardiac valve myxomatous degeneration （PCVMD） compared to pathological findings and to determine the echo features of PCVMD. Methods Echocardiograms were retrospectively compared with pathological findings of 1080 patients who underwent surgery for moderate or severe valve regurgitation. PCVMD of the mitral,aortic and tricuspid valves was retrospectively identified, with a comparison of the echocardiography and pathology findings,to calculate the prevalence of PCVMD,and to summarize its echocardiography features.Results A total of 104 patients were diagnosed with PCVMD （prevalence of 9. 62%） with 117 lesions.Valvular regurgitation were confirmed by echocardiography in all patients（ 100 % ）. Valve morphology change including valve prolapsed, valve thickening and redundancy were confirmed by echocardiography in 101 lesions（86.3 % ）, but suggestive diagnosis were done by echocardiography in only two patients. Conclusions In patients undergoing surgery for valvular regurgitation,a high prevalence of PCVMD was found. PCVMD had distinctive echocardiographic features,suggesting its preoperative diagnosis.