经食道彩色多普勒超声心动图对房间隔膨胀瘤特征及瘤体内血栓形成的观察

Characteristic of atrial septal aneurysm and accompanyed thrombus detected by the transesophageal echocardiography

目的应用经食道彩色多普勒超声心动图观察房间隔膨胀瘤(ASA)瘤体形态及血栓形成情况,以供临床早期预防栓塞性并发症。方法应用经食道彩色多普勒心脏超声诊断仪对26例ASA患者进行检查,观察ASA部位、基底部宽度、最大膨出深度、膨出方向、合并其他心脏疾病,瘤体内血栓等情况。结果①经食道彩色多普勒超声心动图均清晰显示房间隔中部卵圆窝处变薄,其中18例膨向右房侧,2例膨向左房侧,6例于左右房之间往返。膨出度>23.5%左房或右房横径。②ASA合并继发孔型房间隔缺损11例,卵圆孔未闭3例,二尖瓣狭窄1例,二尖瓣脱垂2例,三尖瓣反流1例,室间隔缺损2例,其余6例为孤立性房间隔膨胀瘤。③ASA伴有血栓形成,与外周血管栓塞有关,6例血栓形成患者,2例瘤体内存在附壁血栓,3例左房血栓,1例位于左心耳处。临床追踪4例发生脑卒中。结论经食道彩色多普勒超声心动图能直观显示ASA的发生部位、形态、瘤体大小、膨出度及运动方向,可早期发现瘤体内及心房血栓形成。

Objective To investigate the characteristic of atrial septal aneurysm（ASA） and accompanyed thrombus by transesophageal echocardiography. Methods Twenty-six patients with ASA were diagnosed by color Doppler echocardiography with multiple plane view. The following parameters were measured： the width of basal