Radford D J, Bloom K R, Izukawa T, Moes C A, Rowe R D
Circulation. 1976 Jan;53(1):80-5. doi: 10.1161/01.cir.53.1.80.
Aortic root echocardiograms were recorded from 89 patients whose aortic valves had also been adequately defined by selective angiography or viewed surgically or at autopsy. The eccentricity index (E.I.) of the aortic leaflets was measured at the onset of diastole and an E.I. of 1.3 or greater was taken as abnormal. Of 31 patients with isolated nonobstruced or mildly obstructed bicuspid aortic valves (7 viewed previously at valvotomy and 24 diagnosed radiologically) 23 (74%) had an abnormal E.I. Varying eccentricity occurred in some of these patients. Central leaflet echoes (E.I. of 1.0 to 1.25) were present in the other eight patients. All 14 patients with nonobstructed tricuspid aortic valves had central echoes. Additional multilayered diastolic echoes were found in patients with bicuspid aortic valves as well as in two patients with abnormal tricuspid aortic valves. The valves of 13 patients with aortic stenosis or incompetence were viewed surgically and the E.I. was abnormal in all patients with a bicuspid aortic valve in this group. Aortic leaflet echo findings were not diagnostically helpful in ten patients with tetralogy of Fallot, one of whom had a normal E.I. with a surgically confirmed bicuspid aortic valve. Of 21 patients with VSD only one had a bicuspid aortic valve but six had an abnormal E.I. This false positive sign was related to a high membranous VSD, sometimes with aortic valve prolapse. It is concluded that an E.I. of greater than or equal to 1.3 in the absence of an associated VSD is diagnostic of a bicuspid aortic valve and can be expected to be found in approximately three-quarters of subjects with this abnormality.
对89例患者进行了主动脉根部超声心动图检查，这些患者的主动脉瓣已通过选择性血管造影、手术观察或尸检得到充分明确。在舒张期开始时测量主动脉瓣叶的偏心指数（E.I.），E.I.大于或等于1.3被视为异常。在31例孤立性无梗阻或轻度梗阻的二叶式主动脉瓣患者中（7例曾接受瓣膜切开术，24例经放射学诊断），23例（74%）E.I.异常。其中一些患者出现了不同程度的偏心。另外8例患者出现中央瓣叶回声（E.I.为1.0至1.25）。所有14例无梗阻的三叶式主动脉瓣患者均有中央回声。在二叶式主动脉瓣患者以及2例异常三叶式主动脉瓣患者中还发现了额外的多层舒张期回声。对13例主动脉狭窄或关闭不全患者的瓣膜进行了手术观察，该组中所有二叶式主动脉瓣患者的E.I.均异常。主动脉瓣叶回声表现对10例法洛四联症患者的诊断无帮助，其中1例E.I.正常，但手术证实为二叶式主动脉瓣。在21例室间隔缺损患者中，只有1例有二叶式主动脉瓣，但6例E.I.异常。这种假阳性体征与高位膜周部室间隔缺损有关，有时伴有主动脉瓣脱垂。结论是，在无相关室间隔缺损的情况下，E.I.大于或等于1.3可诊断为二叶式主动脉瓣，预计约四分之三的该异常患者会出现此情况。
