室间隔夹层瘤的超声心动图特征及病因分析

摘要

目的 总结超声心动图诊断的室间隔夹层瘤的超声特征,并对其病因进行研究.方法 对13例室间隔夹层瘤的超声心动图检查资料进行回顾性分析,总结其超声心动图特征并对发病原因进行分析.结果 13例患者中自右冠窦部位破入室间隔11例:5例为单纯右冠窦瘤破入室间隔,1例为主动脉瓣二叶畸形并右冠窦瘤破入室间隔,4例为感染性心内膜炎主动脉瓣或瓣周感染所致,1例主动脉瓣机械瓣置换术后瓣环撕脱所致,其超声心动图均表现为室间隔基底部夹层瘤,将室间隔分为两层形成中间的囊腔,破口均起源于右冠窦部位.急性心肌梗死引起室间隔夹层瘤2例.结论 超声心动图能对室间隔夹层作出准确诊断,并对其病因学进行分析,对临床治疗策略的制定有指导作用.%Objective To summary the echocardiographie features of the patients with dissection into interventricular septum (IVS) and to analyze the etiology.Methods The data of 13 cases with the dissection into the interventricular septum diagnosed by echocardiography were reviewed to summarize the echocardiographic features and the analysis of etiology.Results Among the 13 patients with dissection into IVS,11 patients were dissected into IVS from the right sinus of Valsalva (SOV),in which 5 patients were from single aneurysm of the right SOV,one patient was from a combination of a bicuspid aortic valve and right SOV,4 patients were from aortic valve infection of infective endocarditis,and one patient was induced by severe paravalvular leak after mechanical aortic valve prosthetic replacement was complicated by annular detachment.In all 11 patients,eehocardiography showed a dissecting cystic-like mass in the IVS from the base to mid septum or confined to the septal base.The path of the dissection in all these patients was traced to the right SOV.In the other 2 patients,IVS dissection followed septum rupture due to a myocardial infarction.Conclusions Echocardiography could accurately diagnose dissections of the IVS and to analyze the etiology,which is very helpful to make the clinical medical strategy.