Miyatake K, Yamamoto K, Park Y D, Izumi S, Yamagishi M, Sakakibara H, Nimura Y
J Am Coll Cardiol. 1986 Nov;8(5):1235-9. doi: 10.1016/s0735-1097(86)80407-7.
It has been difficult to diagnose mitral regurgitation due to valve perforation using either noninvasive or invasive methods, differentiating it from that resulting from incomplete coaptation of the mitral valve. This report describes three patients with infective endocarditis and mitral valve perforation, which was definitively diagnosed by the real-time two-dimensional Doppler flow imaging technique. In these three patients, B-mode echocardiography demonstrated an echo interruption on the anterior mitral leaflet. However, it was not certain whether this interruption was simply an echo dropout or indicated an interruption of the valve tissue. Doppler flow imaging then demonstrated unusual flow in the vicinity of the echo interruption, which appeared to flow from the left ventricular cavity into the left atrial cavity across the midportion of the anterior mitral valve leaflet during systole and in the opposite direction during diastole. This was interpreted as mitral valve perforation. In general, Doppler flow imaging may play a complementary role with B-mode echocardiography in cardiac diagnosis.
无论是采用非侵入性还是侵入性方法，都很难诊断出因瓣膜穿孔导致的二尖瓣反流，并将其与二尖瓣瓣叶不完全对合所导致的二尖瓣反流区分开来。本报告描述了3例感染性心内膜炎合并二尖瓣穿孔的患者，二尖瓣穿孔通过实时二维多普勒血流成像技术得以明确诊断。在这3例患者中，B型超声心动图显示二尖瓣前叶有回声中断。然而，尚不能确定这种中断仅仅是回声失落还是表明瓣膜组织中断。随后，多普勒血流成像显示回声中断附近有异常血流，在收缩期似乎从左心室腔穿过二尖瓣前叶中部流入左心房腔，而在舒张期则呈相反方向。这被解释为二尖瓣穿孔。一般来说，在心脏诊断中，多普勒血流成像可能与B型超声心动图起到互补作用。
