彩色多普勒超声心动图对主动脉窦瘤的诊断价值

Diagnostic Value of Color Doppler Echocardiography in Sinus of Valsalva Aneurysms

目的 :旨在探讨彩色多普勒超声心动图 (CDE)诊断主动脉窦瘤的临床价值。方法 :观察分析 115例主动脉窦瘤CDE图像特征及规律性并与手术对照。结果 :95例源于右冠状动脉窦 ,19例源于无冠状动脉窦 ,1例源于左冠状动脉窦 ;窦瘤破入右心室 95例 ,破入右心房 18例 ,破入左心室 1例 ,破入室间隔 1例。合并室间隔缺损 79例 ,主动脉瓣脱垂及反流 5 5例 ,心内膜炎 2 9例 ,其它房间隔缺损、动脉导管未闭分别为 4、9例。术前CDE诊断结论与手术符合率达 99% ,合并室间隔缺损的检出率为 91%。本组合并室间隔缺损占整个病例的 68% ,占窦瘤破入右心室的 84%之多。合并主动脉瓣脱垂或反流本组检出率高于手术所见 (62 /5 5 )。结论 :CDE可以判明主动脉窦瘤的精确的解剖 ,包括窦瘤的来源部位、形态、大小、血流动力学影响 ,是否合并其它心脏畸形等。患者经CDE检查后不必作其他辅助性诊断检查就进行手术是安全、准确、可靠的。

Objective: To explore the diagnostic value of color Doppler echocardiography(CDE) in sinus of Valsalva aneurysms Methods: One hundred and fifteen patients were examined for CDE characteristics and regularity in sinus of Valsalva aneurysms The results were compared with the surgical operations Results: The right coronary sinus was involved in 95 cases,noncoronary sinus in 19 cases and the left coronary sinus in 1 case Rupture into the right ventricle,right atrium,left ventricle and ventricular septum occurred in 94,18,1,1 cases,respectively The associated cardiac anomalies included ventricular septal defect(VSD) ( n= 79,68%),aortic valve prolapse or regurgitation ( n= 55,48%),endocarditis ( n= 29,25%),arterial septal defect(ASD) ( n= 4,3%),and patent ductus arteriosus(PDA)( n= 9,7%) The diagnostic accuracy in the diagnosis of sinus of Valsalva aneurysms,VSD,endocarditis,PDA and ASD in this study was 99%,91%,89% and 100%,respectively The associated VSD accounted for 68% of all cases and 84% of the ruptured into right ventricle in sinus of Valsava aneurysm.The sensitivity of CDE in detecting sinus of Valsalva aneurysms with aortic valve prolapse or regurgitation was higher than that of operative discovery(62/55) Conclusions: CDE can precisely define the anatomy of the sinus of Valsalva aneurysms and its complications It is safe,accurate and reliable so that no other accessory examinations are needed before operation