多模态超声技术诊断肥厚型心肌病合并心尖部室壁瘤1例
Chinese Journal of Medical Imaging Technology(2020)
Abstract
患者女,74岁,因“胸闷10年加重5天”就诊.心电图未见明显异常.超声:心肌非对称性增厚(17~26 mm),以左心室中部及室间隔各段为著,左心室射血分数约51%,每搏输出量(stroke volumn,SV)32ml;左心室中部收缩早期流速2.8 m/s,峰值压差(peak pressure gradient,PPG) 32 mmHg,收缩中期可见血流空白区,舒张期血流反向,流速2.2 m/s.二维左心室超声造影:心尖部见25 mm×24 mm室壁瘤,瘤壁较薄,伴运动消失及灌注减低;三维超声进一步显示瘤体及瘤颈三维结构,心腔造影结合容积三维成像滤过心肌组织后可见包括室壁瘤在内的心腔形态(图1).诊断:肥厚型心肌病(hypertrophic cardiomyopathy,HCM)合并心尖部室壁瘤.
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