超声心动图对主动脉瓣下狭窄的诊断价值

摘要

目的 探讨超声心动图对主动脉瓣下狭窄(SAS)及其合并畸形的诊断价值.方法 回顾分析16例主动脉瓣下狭窄及其合并畸形患者的超声心动图特征.结果 16例患者于主动脉瓣下左室流出道见线性稍强回声12例,肥厚的肌性结构4例,凸向左室流出道,致其变窄,收缩期血流呈五彩镶嵌的高速湍流信号,连续多普勒测得高速湍流频谱,峰速2.1～6.3m/s,压差18～160 mm Hg;合并畸形依次为室间隔缺损6例,动脉导管未闭3例,右室双出口或主动脉瓣二瓣化畸形各2例,主动脉瓣狭窄、法洛四联症、大动脉转位及右冠窦瘤破入右室各1例.结论 超声心动图能对主动脉瓣下狭窄进行形态学及血流动力学的综合评估,进而指导临床治疗.%Objective To explore the value of echocardiographic in diagnosis of subvalvular aortic stenosis (SAS). Methods Sixteen cases of SAS were retrospectively reviewed. Results Linear strong echo was found in 12 cases and hypertrophic muscular structure was found in 4 cases, which protruded into the narrowed left ventricular outflow tract(LVOT) in these 16 cases. High velocity turbulent flow with mosaic color was observed in systolic phase, and high velocity spectrum was measured by continuous wave Doppler. Peak velocity of LVOT flow ranged from 2. 1 m/s to 6. 3 m/s, and the pressure gradient reached to 18 ~ 160 mm Hg. Common accompanied malformations were ventricular septum defect(6 cases), patent ductus arteriosus(3 cases) , double outlet right ventricle, or bicuspid aortic valve (2 cases each) , aortic stenosis, tetralogy of Fallot, transposition of the great arteries, and right sinus of Valsava aneurysm ( 1 case each). Conclusion Echocardiography can provide a comprehensive evaluation of morphological and hemodynamic changes in SAS and guide clinical treatment .