Baur H R, Daniel J A, Nelson R R
Am J Cardiol. 1982 Jul;50(1):191-6. doi: 10.1016/0002-9149(82)90028-5.
The differentiation of left ventricular aneurysm from diffuse left ventricular dilation and hypokinesia may have important therapeutic consequences. Thus the diagnostic accuracy of wide angle two dimensional echocardiography for the detection of left ventricular aneurysm was evaluated in a prospective study of 26 consecutive patients with the clinical suspicion of left ventricular aneurysm referred over a 10 month period. Every patients was examined with two dimensional echocardiography and left ventricular cineangiography, and findings were interpreted by two independent observers. A dilated hypokinetic left ventricle without aneurysm formation on cineangiography in nine patients was identified in all with two dimensional echocardiography. A left ventricular aneurysm on cineangiography in 17 patients was correctly identified in 14 with the two dimensional study, as were the site and extent of the lesion (apical in 12, anterior in 1 and inferior in 1). One apical aneurysm was interpreted on the two dimensional study as apical dyskinesia; one anterior and one posterobasal aneurysm were missed with this technique. Mural thrombi were correctly identified with two dimensional echocardiography in seven of seven patients. It is concluded that two dimensional echocardiography is an accurate noninvasive method that allows differentiation of left ventricular aneurysm from diffuse left ventricular dilation in the majority of patients. It provides information regarding the resectability of the aneurysm and may obviate cineangiography in many cases.
鉴别左心室室壁瘤与弥漫性左心室扩张及运动减弱可能具有重要的治疗意义。因此，在一项为期10个月的前瞻性研究中，对连续26例临床怀疑患有左心室室壁瘤的患者进行了评估，以确定广角二维超声心动图检测左心室室壁瘤的诊断准确性。每位患者均接受了二维超声心动图和左心室电影血管造影检查，检查结果由两名独立的观察者解读。二维超声心动图能够识别出所有9例在电影血管造影中显示为无室壁瘤形成的扩张性运动减弱左心室患者。17例在电影血管造影中显示为左心室室壁瘤的患者，二维超声心动图正确识别出了其中14例，同时还能确定病变的部位和范围（12例为心尖部，1例为前壁，1例为下壁）。二维超声心动图将1例心尖部室壁瘤误诊为心尖部运动障碍；该技术漏诊了1例前壁和1例后基底室壁瘤。二维超声心动图正确识别出了7例患者中的7例附壁血栓。结论是，二维超声心动图是一种准确的非侵入性方法，能够在大多数患者中鉴别左心室室壁瘤与弥漫性左心室扩张。它提供了有关室壁瘤可切除性的信息，并且在许多情况下可以避免进行电影血管造影检查。
