超声心动图诊断先天性降落伞二尖瓣畸形的应用价值

Echocardiographic diagnosis of parachute mitral valve

目的评价超声心动图诊断先天性降落伞二尖瓣畸形的应用价值。方法回顾性分析我院自2005年1月至2012年12月诊治的12例降落伞二尖瓣畸形患者的超声心动图特征及相关临床资料，分析内容包括二尖瓣瓣叶、腱索、乳头肌形态与位置、瓣叶的活动及合并的心血管畸形。结果①12例患者二尖瓣瓣叶均有不同程度增厚，回声增强，舒张期开放受限，短轴切面均可观察到瓣叶开口偏心征象，2例收缩期二尖瓣闭合欠佳。②左室腔仅见一组乳头肌，并可见二尖瓣（左侧房室瓣）腱索均汇聚于单组乳头肌上，其中乳头肌位置位于左室壁后内侧4例，前外侧3例，后壁偏中央、心尖部各2例，后外侧1例。③1例为单纯降落伞二尖瓣畸形，余11例患者均合并不同类型心血管畸形。④11例患者舒张期二尖瓣口前向血流加速，峰值速度2．0～3．2m／s，2例收缩期见轻度反流血流信号。结论先天性降落伞二尖瓣畸形具有典型的超声心动图特征，超声心动图可为该病的临床诊断与治疗提供敏感与特异性高的检查信息。

Objective To explore the value of echocardiography in the diagnosis of the parachute mitral valve（PMV）. Methods The echocardiographic characteristics of 12 patients with PMV between 2005 and 2012 were reviewed retrospectively,including the morphology, movement and blood flow of mitral valve apparatus,and other associated cardiac abnormalities. Results Of the mitral valve leaflets in these 12 cases, all were thickened and opened restricted in diastole. Axial view showed that in all cases mitral valves opened eccentrically and in 2 cases they didn＇t close tightly. Each patient only had single papillary muscle in left ventricle, which received all chords of mitral valves. Of papillary muscles in these patients,4 were located at posteromedial wall,3 at anterolateral wall,2 at middle posterior wall,2 at apical wall,and 1 at posterolateral wall. Of the 12 patients,only one were simple PMV, 11 had associated cardiovascular anomalies,2 had mild regurgitation in systolic period and 11 had increased trans-valve peak flow velocity. Conclusions Echocardiography is reliable in the diagnosis of PMV, which could provide a comprehensive evaluation of valvular lesions and other associated cardiovascular anomalies.