Yoshikawa J, Kato H, Yanagihara K, Owaki T, Okumachi F, Takagi Y, Yoshida K, Yamaoka S
J Cardiogr. 1981 Mar;11(1):59-66.
M-mode and cross-sectional echocardiograms of 3 cases with vegetative endocarditis in the right-sided heart were reported. The location of vegetative lesions was the tricuspid valve in one, the parietal band of the right ventricle and chordae tendinae in one, and the pulmonary artery wall in the remaining patient. Ruptured chordae tendinae were observed in the patient with tricuspid valve vegetation. M-mode echocardiography detected vegetative lesions in all patients. However, the precise size and location of these lesions, and a complication of the destructive process were not evaluated by M-mode echocardiography. On the other hand, cross-sectional echocardiography not only documented the presence but also assessed the morphologic characteristics of the lesions, since this technique provides spatial orientation concerning moving structures. Furthermore, ruptured chordae tendineae in the patient with tricuspid valve vegetation was correctly estimated. However, the lesions should be differentiated from other conditions including a localized calcified lesion, abscess and thrombus. In conclusion, cross-sectional echocardiography in combination with M-mode echocardiography is recommended in diagnosing vegetative lesions in the right-sided heart.
报告了3例右侧心内膜炎赘生物患者的M型和横截面超声心动图。赘生物病变的位置,1例位于三尖瓣,1例位于右心室壁带和腱索,其余患者位于肺动脉壁。在三尖瓣赘生物患者中观察到腱索破裂。M型超声心动图在所有患者中均检测到赘生物病变。然而,M型超声心动图未评估这些病变的精确大小和位置以及破坏性过程的并发症。另一方面,横截面超声心动图不仅记录了病变的存在,还评估了病变的形态特征,因为该技术提供了有关移动结构的空间定位。此外,正确估计了三尖瓣赘生物患者的腱索破裂。然而,这些病变应与其他情况相鉴别,包括局限性钙化病变、脓肿和血栓。总之,建议将横截面超声心动图与M型超声心动图结合用于诊断右侧心内膜赘生物病变。