【摘要】 目的探讨经食管三维超声心动图定位左心房内黏液瘤的准确度及重要性,初步分析造成二尖瓣口梗阻的影响因素。方法全部患者进行常规或术中经食管三维超声心动图检查,确定黏液瘤附着在左心房的位置,所得结果对比手术所见。结果经食管三维超声心动图显示左心房黏液瘤附着于房间隔卵圆窝18例、心房顶壁(无冠窦后方)4例、心房后壁3例、心耳1例,对比手术所见准确度达100%。黏液瘤造成二尖瓣口梗阻16例,无梗阻10例,梗阻组瘤体长径、(瘤体/基底)径线比值、二尖瓣口速度、肺动脉收缩压力间均较无梗阻组高。结论经食管三维超声心动图能准确定位左心房黏液瘤,对外科选择术式十分重要。瘤体附着位置、瘤体长径及基底(蒂)宽径为影响二尖瓣口梗阻的相关因素。更多还原

【Abstract】 Objective To explore the importance and accuracy of 3Dtransesophageal echocardiography(3D TEE)in evaluating location of left atrial myxoma.To analyze the influence factors for mitral valve obstruction.Methods Twenty-six patients with left atrial myxoma underwent 3DTTE to locate myxoma in left atrium,the results were compared with operative findings.To measure body length and base width of myxoma,acquire the mitral valve velocity and pulmonary artery systolic pressure.Results Comparing surgery findings,the accuracy rate of 3DTEE for location of left atrial myxomas is 100%.Eighteen cases were attached to the interatrial septum oval fossa,four cases were attached to the roof atrial wall(no coronary sinus rear),three cases were attached to rear atrial wall,1case was attached to left atrial auricle.Myxomas make mitral valve obstruction in 16 cases,no obstruction in10 cases.The length of tumors,tumors/base ratio,mitral valve velocity,the pulmonary artery systolic pressure in obstruction group were higher than no obstruction group.Conclusions 3D TEE plays an important role in locating the myxoma in left atrial.The body length and base width of myxoma,adherent location of myxoma are relevant factors of mitral valve with obstruction.更多还原