Guo D W, Cheng T O, Lin M L, Gu Z Q
Department of Radiology, Shanghai Chest Hospital, China.
Am Heart J. 1987 Nov;114(5):1169-77. doi: 10.1016/0002-8703(87)90193-1.
Of 105 cases of lesions of the sinus of Valsalva found over a 25-year period at the Shanghai Chest Hospital, 90 were ruptured sinuses or sinus aneurysms and 15 were unruptured aneurysms. The cases were classified roentgenologically according to the method of Sakakibara and Konno: 64.5% were type I, 23.7% type II, 1.1% type IIIv, 6.4% type IIIa, 1.1% type IIIa + v, and 3.2% type IV. A new and simplified method of classification has been devised in the Shanghai Chest Hospital and shows the highest incidence to be the type of aneurysm of the sinus of Valsalva associated with ventricular septal defect. On aortography three types of morphologic changes--aneurysmal formation, enlargement of the sinus with no definite aneurysm, and sinus rupture with no enlargement or aneurysmal formation--are observed. Angiographically, shunting from ruptured sinus or sinus aneurysm begins in middiastole and gradually increases to end diastole. Aortic insufficiency, if present, usually begins in early diastole and extends over the whole diastolic phase in a decrescendo fashion. Special attention should be paid to the differentiation between ruptured sinus of Valsalva with or without aneurysmal formation and ventricular septal defect with aortic insufficiency.
在上海胸科医院25年期间发现的105例瓦尔萨尔瓦窦病变中，90例为破裂窦或窦瘤，15例为未破裂瘤。根据Sakakibara和Konno的方法进行X线分类：I型占64.5%，II型占23.7%，IIIv型占1.1%，IIIa型占6.4%，IIIa + v型占1.1%，IV型占3.2%。上海胸科医院设计了一种新的简化分类方法，显示瓦尔萨尔瓦窦瘤合并室间隔缺损类型的发病率最高。在主动脉造影上，观察到三种形态学改变——瘤样形成、窦扩大但无明确瘤体、窦破裂但无扩大或瘤样形成。血管造影显示，破裂窦或窦瘤的分流始于舒张中期，并逐渐增加至舒张末期。如果存在主动脉瓣关闭不全，通常始于舒张早期，并以递减方式延伸至整个舒张期。应特别注意有或无瘤样形成的破裂瓦尔萨尔瓦窦与合并主动脉瓣关闭不全的室间隔缺损之间的鉴别。
