【摘要】 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。更多还原

【Abstract】 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 part, maximal excursion or protrusion beyond the plane of the atrial septum, direction of protrusion,spontaneous oscillation of the ASA during normal cardiorespiratory cycle, the presence of thrombi attaching to the wall, atrial septal defect, other structural abnormalities associated with ASA. Results Twenty-six cases were accurately diagnosed by imaging character of TEE. All the echocardiographic clearly showed a thinning part in the middle of the interatrial septum known as fossa ovalis. Among them, 18 cases projected toward to right atrium, 2 cases projected to left atrium and 6 cases in a round trip between left and right atrium. The output degree of ASA>23.5% left atrial or right atrial horizontal diameter. ASA usually existed with other heart diease, we found 11 atrial septal defect, 3 fossa ovalis peforation, 1 mitrol valve stenosis, 2 mitro valve prolapse, 1 tricuspid valve prolapse, 2 ventricular septal defect, the other six were isolated atrial septal aneurysm. Thrombi developed in 6 ASA patiants, 2 attached to the atrial septal wall, 3 in left atrium, 1 in left atrium appendage. Conclusion The charicteristic of ASA and assosiated heart diseases and thrombosis can be exactly described by TEE, and TEE may provide a reliable basis for clinical diagnosis and treatment.更多还原