心肌致密化不全的超声诊断

Ultrasonographic diagnosis of noncompaction of ventricular myocardium

目的通过对心肌致密化不全(NVM)的超声影像特征分析,探讨彩色多普勒超声心动图对该病的诊断及鉴别诊断。方法采用彩色多普勒超声心动图对临床心功能不全及心脏扩大的患者进行多切面扫查,以获取心脏形态、结构及血流信号,重点观察近心尖1/3的心肌与心内膜。结果 18例超声诊断为NVM,其中16例为左心室受累,2例右心室受累。超声心动图主要表现为:(1)左室或右室中、下1/3至心尖的心腔内可见异常粗大的肌小梁和其间深陷的隐窝;受累室壁增厚分为两层,致密层较薄而非致密层较厚,收缩末期非致密化层与致密化层之比>2;(2)受累腔室扩大,室壁变薄,运动减弱,收缩增厚率减低;(3)彩色多普勒显示隐窝内的低速血流与心腔内高速血流相通。结论彩色多普勒超声心动图是诊断及鉴别诊断NVM的首选方法。

Objective To explore the echocardiographic characteristics of noncompaction of ventricular myocardium （NVM）, and to assess its value in the diagnosis and differential diagnosis of color doppler ultrasound of NVM. Methods The patients with clinical heart failure and enlargement of the heart was given Multi-slice scanning used color doppler echocardiography to get cardiac morphology, structure and flow signals. Near apical 1/3 of the myocardium and endocardium was observed. Results Eighteen cases of patients were diagnozed as NVM by ultrasound, of whom 16 cases were left ventricular involvement, 2 cases were right ventricular involvement. The characteristics of echocardiography included： （1） Left ventricle or right ventricle, the lower 1/3 to the apex of the heart cavities had unusually thick muscle trabeculae and during which deep-crypt; involvement of the wall thickening was divided into two layers, dense layer was thin, and non- dense layer was thick, non-dense layer and densification ratio 2 at systolic; （2） The involved ventricular chambers expanded, the wall became thinner, the movement became weaker, the contraction thickening rate became lower; （3） The color doppler flow imaging showed that blood in the muscular trabeculations tissues was circulate to chambers of the hert. Conclusion The color doppler echocardiography can be used as the first method for the diagnosis and differential diagnosis of noncompaction of ventricular myocardium.