Vogt J, Rupprath G, de Vivie R, Beuren A J
Pediatr Cardiol. 1983 Oct-Dec;4(4):253-8. doi: 10.1007/BF02278870.
The value of cross-sectional sector echocardiography in the visualization of discrete subaortic stenosis (DSS) was investigated using an 80 degrees phased-array sector scanner with simultaneously derived M-mode outputs. Thirty-three patients (including 22 postoperative patients) with proven DSS were investigated and divided into two groups: group I--discrete membranous type; and group II--diffuse fibromuscular type. In group I (15 patients), two isolated subaortic ridges were identified as discrete linear echoes in the long axis of the outflow tract in five patients. A single distinct and isolated linear echo was observed in three patients, whereas in another five the ridges appeared to be attached to the ventricular septum and/or to the base of the anterior mitral leaflet. In two patients with mild DSS, a false-negative diagnosis was made. Only 2 out of 12 patients in this group showed a short remnant of the ridge after surgical revision. In group II, a more generalized or long-segment narrowing was present in 18 patients; in 14 of them the ridges were continuous with the walls of the outflow tract. Eight out of ten patients reexamined following resection of fibromuscular tissue still had residual obstruction. Analysis of the simultaneous M-mode recordings revealed that the transient appearance of the ridge in the outflow tract depended on the normal movement of the heart within the chest, on the lengthening of the membrane itself, and on the angle between the ultrasound beam and the membrane during different cardiac cycles. Our study shows that a spectrum of one- and two-dimensional patterns exists depending on the nature of the obstructing lesion. Cross-sectional sector echocardiography provides more direct visualization and characterization of various types of DSS than M-mode echocardiography does.
使用一台能同时输出M型超声心动图的80度相控阵扇形扫描仪，研究了横断面扇形超声心动图在显示孤立性主动脉瓣下狭窄（DSS）方面的价值。对33例经证实患有DSS的患者（包括22例术后患者）进行了研究，并将其分为两组：第一组——孤立性膜型；第二组——弥漫性纤维肌型。在第一组（15例患者）中，5例患者在流出道长轴上可将两条孤立的主动脉瓣下嵴识别为离散的线性回声。3例患者观察到单个明显孤立的线性回声，而在另外5例患者中，这些嵴似乎附着于室间隔和/或二尖瓣前叶基部。2例轻度DSS患者被误诊为阴性。该组12例患者中只有2例在手术矫正后显示嵴的残留较短。在第二组中，18例患者存在更广泛或长节段狭窄；其中14例患者的嵴与流出道壁相连。在切除纤维肌组织后复查的10例患者中有8例仍有残余梗阻。对同步M型记录的分析显示，流出道中嵴的短暂出现取决于心脏在胸腔内的正常运动、膜本身的延长以及不同心动周期中超声束与膜之间的角度。我们的研究表明，根据梗阻病变的性质存在一系列一维和二维模式。横断面扇形超声心动图比M型超声心动图能更直接地显示和鉴别各种类型的DSS。
