![[學(xué)習(xí)]二維超聲心動(dòng)圖常用切面及選擇](https://static.zsdocx.com/FlexPaper/FileRoot/2019-9/19/23/6a218721-7f84-470f-b5f3-a3892ff23cbb/pic1.gif)
簡(jiǎn)介：1胸骨旁左室長(zhǎng)軸切面,1正常解剖結(jié)構(gòu)的超聲表現(xiàn)心底部自前向后分別為右室流出道、主動(dòng)脈根部及左心房，正常三者內(nèi)徑基本相同。中部由前向后依次為右室前壁、右室流出道、室間隔、左室流出道、左室流入道二尖瓣前、后葉及腱索。心尖部自前向后依次為室間隔、左室腔及左室后壁。2選用范圍1右主流出道評(píng)價(jià)右窒流出道有無(wú)狹窄、擴(kuò)大等。2主動(dòng)脈根部；評(píng)價(jià)主動(dòng)脈根都病變，包括有無(wú)管壁增厚、夾層，管腔擴(kuò)大、狹窄竇部擴(kuò)大、瘤樣膨出或破口瓣葉右及無(wú)冠瓣增厚、纖維化或鈣化、贅生物、脫垂、梿枷樣運(yùn)動(dòng)、開(kāi)放受限或關(guān)團(tuán)不全等，并可分別測(cè)量瓣環(huán)、竇部、嵴部及開(kāi)主動(dòng)脈徑，3左心房；觀察并測(cè)量左心房大小、左房?jī)?nèi)有無(wú)血栓、腫瘤、隔膜、左房下后方冠狀靜脈竇有無(wú)擴(kuò)大，后方異常管道結(jié)構(gòu)肺總靜脈。4右室前壁；評(píng)價(jià)右室前壁有無(wú)液區(qū)心包積液，心室壁有無(wú)增厚、右室腔大小。5室間隔測(cè)量室間隔厚度肥厚或變薄及運(yùn)動(dòng)幅度減弱或不運(yùn)動(dòng)、回聲室間隔中都連續(xù)中斷肌部間隔缺損，上部與主動(dòng)脈前壁連續(xù)中斷膜周或嵴下型室間隔缺損，主動(dòng)脈騎跨于室間隔上法洛四聯(lián)癥或永存動(dòng)脈干，心尖部室間隔連續(xù)中斷室壁穿孔等。6左室腔及左室后壁測(cè)心腔大小、后壁厚度及運(yùn)動(dòng)幅度、觀察心腔形態(tài)，有無(wú)心尖圓鈍擴(kuò)大、室壁膨出室壁瘤及附壁血栓等。7二尖瓣及瓣器；觀察二尖瓣葉的厚度、回聲強(qiáng)度彈性、開(kāi)閉活動(dòng)、有無(wú)增厚、鈣化、贅生物等異常，鍵索有無(wú)增厚、粘附著于室間隔等，二尖瓣前葉根部與主脈后壁的纖維連續(xù)是否正常，有無(wú)肌性連續(xù)（右室雙出口、大血管轉(zhuǎn)位）。,胸骨旁左室長(zhǎng)軸切面,3正常值①主動(dòng)脈內(nèi)徑胸旁左室長(zhǎng)軸切面，收縮末期徑，環(huán)部前后徑為1626CM，竇部為2439CM，主動(dòng)脈竇上（嵴部）為2134CM，升主動(dòng)脈為2234CM，主動(dòng)脈弓徑為2227CM。②左房?jī)?nèi)徑前后徑（收縮末期徑、主動(dòng)脈竇后方垂直距離）為2433CM。,③右室內(nèi)徑前后徑（舒張末期徑，腱索水平測(cè)）為20CM以下。④左室內(nèi)徑前后徑（腱索水平）舒張末期為3752CM；收縮末期為2336CM。⑤室間隔厚度（舒張末期，腱索水平測(cè)）94士09MM。⑥左室后壁厚度（舒張末期，腱索水平測(cè)）94士08MM。,胸骨旁左室長(zhǎng)軸切面SCHEMATICDIAGRAMOFTHEPARASTERNALLONGAXISVIEWINDIASTOLE,SHOWINGTHEAORTICROOTAO,SINOTUBULARJUNCTIONSTJ,CLOSEDRIGHTCORONARYANDNONCORONARYCUSPSOFTHEAORTICVALVERCCANDNCC,THEOPENANTERIORANDPOSTERIORMITRALVALVELEAFLETSAMVLANDPMVL,ANDTHELEFTVENTRICULARSEPTUMANDPOSTERIORWALLTHEMEDIALPAPILLARYMUSCLEHASBEENSHOWNFORREFERENCE,ALTHOUGHSLIGHTMEDIALANGULATIONISNEEDEDTOVISUALIZETHISTRUCTUREINTHELONGAXISVIEWTHERIGHTVENTRICULAROUTFLOWTRACTRVOTISANTERIOR,WHILETHECORONARYSINUSCSINTHEATRIOVENTRICULARGROOVEANDTHEDESCENDINGAORTADAARESEENPOSTERIORLYTHERIGHTPULMONARYARTERYRPALIESPOSTERIORTOTHEASCENDINGAORTATHEPOSITIONOFTHEPERICARDIUMISINDICATEDBYTHETHINLINENORMALPARASTERNALLONGAXIS2DECHOIMAGESATENDDIASTOLEABOVEANDENDSYSTOLEBELOW,2右室流出道切面,解剖圖,3右室流入道切面,SHOWINGTHERIGHTVENTRICLERVANDATRIUMRA,TRICUSPIDVALVETV,ANDOSTIAOFTHECORONARYSINUSCSANDINFERIORVENACAVAIVC,SCHEMATICAND2DECHOIMAGESINARIGHTVENTRICULARINFLOWVIEW,,4胸骨旁主動(dòng)脈根部短軸切面,1正常結(jié)構(gòu)的超聲表現(xiàn)圖像左側(cè)，從前向后依次為右室流出道、肺動(dòng)脈瓣、肺動(dòng)脈主干及左右肺動(dòng)脈。中部為右室流出道、主動(dòng)脈根部、左房。右側(cè)為右室流入道、三尖瓣、右心房,２此切面選用范圍1測(cè)量主肺動(dòng)脈及左右肺動(dòng)脈徑，評(píng)價(jià)肺動(dòng)脈有無(wú)狹窄或擴(kuò)大。2測(cè)量肺動(dòng)脈瓣環(huán)徑，觀察肺動(dòng)脈瓣開(kāi)、閉運(yùn)動(dòng)，評(píng)價(jià)有無(wú)狹窄（法洛三聯(lián)癥、四聯(lián)癥等）、閉鎖（肺動(dòng)脈閉鎖、假性共干等）。3觀察主、肺動(dòng)脈的空間位置關(guān)系。4測(cè)量右心室流出道內(nèi)徑及前壁厚度，評(píng)價(jià)有無(wú)狹窄擴(kuò)大及增厚，有無(wú)異常結(jié)構(gòu)（隔膜、下移的三尖瓣或腫瘤）。5觀察主動(dòng)脈瓣葉數(shù)目（二瓣或多瓣畸形），厚度及三個(gè)瓣葉的關(guān)系及交界處有無(wú)粘連，瓣葉有無(wú)狹窄及關(guān)閉不全。6觀察主動(dòng)脈竇病變（主動(dòng)脈竇瘤或竇瘤破裂）。7觀察左右冠狀動(dòng)脈開(kāi)口及主干有無(wú)病變（冠狀動(dòng)脈開(kāi)口異常、擴(kuò)大、狹窄或閉塞）。8觀察右房大小及三尖瓣有無(wú)病變（狹窄、關(guān)閉不全、EBSTEIN畸形、三尖瓣閉鎖）。,胸骨旁主動(dòng)脈根部短軸切面,3正常測(cè)值1右室流出道徑（自室上嵴至流出道前壁垂直距離）；舒張末期為1925CM。2主肺動(dòng)脈徑（胸旁主動(dòng)脈根部短軸切面，瓣上1CM處）舒張末期為1525CM。3肺動(dòng)脈瓣環(huán)徑為1122CM，右肺動(dòng)脈徑0816CM，左肺動(dòng)脈徑L014CM。,胸骨旁主動(dòng)脈根部短軸切面SCHEMATICDIAGRAMOFAPARASTERNALSHORTAXISVIEWATTHEAORTICVALVELEVEL,SHOWINGTHERELATIONSHIPBETWEENTHETHREECUSPSOFTHEAORTICVALVERIGHTCORONARYCUSPRCC,NONCORONARYCUSPNCC,LEFTCORONARYCUSPLCCANDTHELEFTATRIUMLA,RIGHTATRIUMRA,RIGHTVENTRICULAROUTFLOWTRACTRVOT,ANDTHEPULMONARYARTERYPAWITHRIGHTRPAANDLEFTLPABRANCHESTHEPOSITIONSOFTHERIGHTCORONARYARTERYRCA,LEFTMAINCORONARYARTERYLMCA,PULMONICVALVE,ANDTRICUSPIDVALVEARESHOWNTWODIMENSIONALECHOCARDIOGRAPHICIMAGESATTHEAORTICVALVELEVELINSYSTOLEABOVEANDDIASTOLEBELOWNOTETHETHREEOPENLEAFLETSOFTHEAORTICVALVEINSYSTOLEANDTHENORMALPERPENDICULARRELATIONSHIPOFAORTICANDPULMONICVALVES,,5．胸骨旁腱索水平短軸切面,1正常結(jié)構(gòu)的超聲心動(dòng)圖表現(xiàn)圖右側(cè)依次顯示左室前壁、側(cè)壁、后壁，中部為室間隔。右前方為右室前壁、右室腔及右室后壁。,2此切面選用范圍①測(cè)量左室腔徑（前后及左右徑），評(píng)價(jià)左室大小，觀察左室壁厚度及室腔形態(tài)（正常左室腔呈圓形），腔內(nèi)顯示乳頭肌上緣或鍵索。②右室腔大小、位置及形態(tài)，有無(wú)擴(kuò)大、轉(zhuǎn)位。3正常測(cè)值左室橫徑舒張末期為3353CM，收縮末期為2442CM。,RELATIONSHIPBETWEENTHESHORTAXISPLANEWITHLEFTVENTRICULARWALLSEGMENTSINDICATED,ANDTHEAPICALFOURCHAMBER,TWOCHAMBER,ANDLONGAXISIMAGEPLANESPERPENDICULARTOTHESHORTAXISPLANE,６心尖四腔切面,１正常解剖結(jié)構(gòu)的超聲心動(dòng)圖表現(xiàn)圖像右側(cè)自上向下依次為左心室、二尖瓣、左房，左側(cè)為右心室、三尖瓣、右房，中央為室間隔、房間隔。,２此切面選用范圍1觀察與測(cè)量心室及心房大小及形態(tài)；2觀察房、室間隔連續(xù)情況；3觀察室壁厚度及運(yùn)動(dòng)、有無(wú)局部運(yùn)動(dòng)異常（心肌缺血、梗死）或膨出（室壁瘤）；4觀察二尖瓣與三尖瓣數(shù)目、形態(tài)及開(kāi)閉情況，測(cè)量?jī)筛羧~根部附著位置間距離（EBSTEIN；5觀察心腔內(nèi)有無(wú)腫物（附壁血栓或心內(nèi)腫瘤）及其附著位置、大小、活動(dòng)情況；6觀察三條（左上、左下、右上）肺靜脈是否均回入左房（肺靜脈異位引流）；7左心房?jī)?nèi)有無(wú)隔膜（三房心）；8評(píng)價(jià)心功能。,心尖四腔切面,3正常測(cè)值①左室長(zhǎng)徑舒張末期為70～84CM，收縮末期為50～64CM。②左房?jī)?nèi)徑上下徑為31～53CM（收縮末期，二尖瓣環(huán)聯(lián)線中點(diǎn)至左房頂部），橫徑為30～53CM。（收縮末期，心房中部）。③右室內(nèi)徑橫徑為25～42CM（舒張末期徑），長(zhǎng)徑為58～78CM（舒張末期徑）。④右房?jī)?nèi)徑為34～4,9CM,橫徑為29～4,5CM（心尖四腔切面，收縮末期上下徑）。,心尖四腔切面SCHEMATICDIAGRAMOFTHEAPICALFOURCHAMBERVIEW,SHOWINGTHERELATIONSHIPSOFTHELEFTANDRIGHTVENTRICLESLVANDRVANDATRIALAANDRAINTHELEFTVENTRICLE,THEPAPILLARYMUSCLE,CHORDAE,ANDANTERIORANDPOSTERIORMITRALLEAFLETSAMVL,PMVLARESEENTHEDESCENDINGAORTADAISSEENINPARTIALCROSSSECTIONLATERALTOTHELEFTATRIUM,WHILETHERIGHTSUPERIORPULMONARYVEINRSPVDRAINSINTOTHELEFTATRIUMADJACENTTOTHEINTERATRIALSEPTUMINTHERIGHTVENTRICLE,THEMODERATORBANDMANDTHEANTERIORANDSEPTALTRICUSPIDVALVELEAFLETSATVLANDSTVLARESEENNOTETHEVENTRICULOATRIALSEPTUMVASSEPARATINGTHELEFTVENTRICLEFROMTHERIGHTATRIUMINASSOCIATIONWITHTHENORMAL,SLIGHTLYMOREAPICALPOSITIONOFTHETRICUSPIDCOMPAREDWITHTHEMITRALVALVEANNULUSTWODIMENSIONALECHOIMAGESINANAPICALFOURCHAMBERVIEWATENDDIASTOLEABOVEANDENDSYSTOLEBELOW,心尖四腔切面,心尖四腔切面SUBCOSTALVIEWSHOWINGALLFOURCARDIACCHAMBERS,,,7心尖兩腔切面,8主動(dòng)脈弓長(zhǎng)軸切面,SCHEMATICAND2DECHOIMAGESOFTHEAORTAINALONGAXISVIEWFROMTHESUPRASTERNALNOTCHWINDOWTHEASCENDINGAORTICAOARCHANDDESCENDINGTHORACICAORTAARESEENWITHTHEORIGINSOFTHELEFTCAROTIDANDSUBCLAVIANARTERIESTHERIGHTPULMONARYARTERYRPALIESIMMEDIATELYINFERIORTOTHEARCH,附心超常見(jiàn)縮寫(xiě)表1,ABBREVIATIONDEFINITION2DTWODIMENSIONALIMAGING3DTHREEDIMENSIONALIMAGINGAMODEAMPLITUDEMODEAATRIALDIASTOLICVELOCITYPEAKAAREASEENINMATHEMATICALFORMULASAPEX2CAPICALTWOCHAMBERVIEWAPEX3CAPICALTHREECHAMBERVIEWALSOKNOWNASAPICALLONGAXISAPEX4CAPICALFOURCHAMBERVIEWAPEX5CAPICALFIVECHAMBERVIEWACTACCELERATIONTIMEAFATRIALFIBRILLATIONAMVLANTERIORMITRALVALVELEAFLETANTANTERIOR,AOAORTAAIAORTICINSUFFICIENCYASAORTICSTENOSISASCASCENDINGASDATRIALSEPTALDEFECTASHASYMMETRICALSEPTALHYPERTROPHYATVLANTERIORTRICUSPIDVALVELEAFLETAVAORTICVALVEAVAAORTICVALVEAREAAVRAORTICVALVEREPLACEMENTBAVBALLOONAORTICVALVULOPLASTYBPBLOODPRESSUREBSABODYSURFACEAREACPROPAGATIONSPEEDOFSOUNDINTISSUE,附心超常見(jiàn)縮寫(xiě)表2,DBDECIBELDP/DTRATEOFCHANGEINPRESSUREOVERTIMEEENERGYECGELECTROCARDIOGRAMEDENDDIASTOLEEDDENDDIASTOLICDIMENSIONEDVENDDIASTOLICVOLUMEEFEJECTIONFRACTIONEPIEPICARDIUMEPSSEPOINTOFSEPTALSEPARATIONESENDSYSTOLEESDENDSYSTOLICDIMENSIONESPVRENDSYSTOLICPRESSUREVOLUMERELATIONSHIPESVENDSYSTOLICVOLUME,CADCORONARYARTERYDISEASECATHCARDIACCATHETERIZATIONCBVCATHETERBALLOONVALVULOPLASTYCHCHORDAECMCENTIMETERCM/SCENTIMETERPERSECONDCOCARDIACOUTPUTCONTEQCONTINUITYEQUATIONCOSCOSINECSCORONARYSINUSCSACROSSSECTIONALAREACXCIRCUMFLEXCORONARYARTERYDDIAMETERDADESCENDINGAORTA,附心超常見(jiàn)縮寫(xiě)表3,ETTEXERCISETREADMILLTESTΔ?FREQUENCYSHIFT?FREQUENCYFLFALSELUMENFNNEARZONEFORESONANCEFREQUENCYOPERATINGFREQUENCYFSSCATTEREDFREQUENCYFSVFORWARDSTROKEVOLUMEFTTRANSMITTEDFREQUENCYFXFUNCTIONHCMHYPERTROPHICCARDIOMYOPATHYHPRFHIGHPULSEREPETITIONFREQUENCYHRHEARTRATEHVHEPATICVEINIINTENSITYIASINTERATRIALSEPTUM,INFINFERIORIVINTRAVENOUSIVCINFERIORVENACAVAIVCTISOVOLUMICCONTRACTIONTIMEIVRTISOVOLUMICRELAXATIONTIMEKHZKILOHERTZLLENGTHLALEFTATRIUMLAALEFTATRIALAPPENDAGELADLEFTANTERIORDESCENDINGCORONARYARTERYLAELEFTATRIALENLARGEMENTLAOLEFTANTERIOROBLIQUELATLATERALLAXXPARASTERNALLONGAXISLCCLEFTCORONARYCUSPLLDLEFTLATERALDECUBITUS,附心超常見(jiàn)縮寫(xiě)表4,MSMITRALSTENOSISMVMITRALVALVEMVAMITRALVALVEAREAMVIMITRALVALVEINSUFFICIENCYMYXMYXOMANCCNONCORONARYCUSPΔPCHANGEINPRESSUREPPRESSUREPAPULMONARYARTERYPANPSEUDOANEURYSMPAPPULMONARYARTERYPRESSUREPDPULSEDDOPPLERPDAPATENTDUCTUSARTERIOSISPEPERICARDIALEFFUSIONPEPPREEJECTIONPERIODPISAPROXIMALISOVELOCITYSURFACEAREA,LMCALEFTMAINCORONARYARTERYLPALEFTPULMONARYARTERYLSPVLEFTSUPERIORPULMONARYVEINLVLEFTVENTRICLELVEDDLEFTVENTRICULARENDDIASTOLICDIMENSIONLVEDPLEFTVENTRICULARENDDIASTOLICPRESSURELVESDLEFTVENTRICULARENDSYSTOLICDIMENSIONLVHLEFTVENTRICULARHYPERTROPHYLVILEFTVENTRICULARINFLOWLVOLEFTVENTRICULAROUTFLOWLVOTLEFTVENTRICULAROUTFLOWTRACTMMODEMOTIONMODEMACMITRALANNULARCALCIFICATIONMBMODERATORBANDMIMYOCARDIALINFARCTION,附心超常見(jiàn)縮寫(xiě)表5,PMPAPILLARYMUSCLEPMVLPOSTERIORMITRALVALVELEAFLETPOSTPOSTERIORPIPULMONARYINSUFFICIENCYPRFPULSEREPETITIONFREQUENCYPRFRPEAKRAPIDFILLINGTIMEPSPULMONARYSTENOSISPVPULMONICVALVEPTCAPERCUTANEOUSTRANSLUMINALCORONARYANGIOPLASTYPVPULMONARYVEINPVCPREMATUREVENTRICULARCONTRACTIONPWTPOSTERIORWALLTHICKNESSQVOLUMEFLOWRATEQPPULMONICVOLUMEFLOWRATEQSSYSTEMICVOLUMEFLOWRATERARIGHTATRIUM,RAERIGHTATRIALENLARGEMENTRAORIGHTANTERIOROBLIQUERAPRIGHTATRIALPRESSURERCARIGHTCORONARYARTERYRCCRIGHTCORONARYCUSPRFREGURGITANTFRACTIONRJREGURGITANTJETROAREGURGITANTORIFICEAREARPARIGHTPULMONARYARTERYRSPVRIGHTSUPERIORPULMONARYVEINRSVREGURGITANTSTROKEVOLUMERVRIGHTVENTRICLERVERIGHTVENTRICULARENLARGEMENTRVHRIGHTVENTRICULARHYPERTROPHYRVIRIGHTVENTRICULARINFLOWRVORIGHTVENTRICULAROUTFLOW,附心超常見(jiàn)縮寫(xiě)表6,TGATRANSPOSITIONOFTHEGREATARTERIESTGCTIMEGAINCOMPENSATIONTITRICUSPIDVALVEINSUFFICIENCYTLTRUELUMENTOFTETRALOGYOFFALLOTTPVTIMETOPEAKVELOCITYTSTRICUSPIDSTENOSISTSVTOTALSTROKEVOLUMETTETRANSTHORACICECHOCARDIOGRAPHYTVTRICUSPIDVALVEVVELOCITYVVOLUMEVEGVEGETATION,RVOTRIGHTVENTRICULAROUTFLOWTRACTSAMSYSTOLICANTERIORMOTIONSAXXPARASTERNALSHORTAXISSCSUBCOSTALSSNSUPRASTERNALNOTCHSTSEPTALTHICKNESSSTJSINOTUBULARJUNCTIONSTVLSEPTALTRICUSPIDVALVELEAFLETSVSTROKEVOLUMESVCSUPERIORVENACAVASWMASEGMENTALWALLMOTIONABNORMALITYT1/2PRESSUREHALFTIMETTHROMBUSTEETRANSESOPHAGEALECHOCARDIOGRAPHY,
下載積分： 4 賞幣
上傳時(shí)間：2024-01-06
頁(yè)數(shù)： 22
大?。?2.62(MB)
子文件數(shù)：
