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心室动脉瘤的放射学诊断。36例手术病例报告(作者译)

[Radiological diagnosis of ventrycular aneurysms. A report on 36 operated cases (author's transl)].

作者信息

Le Cudonnec B, Vasile N, Kulas A, Bornes J C, Ferrané J

出版信息

J Radiol Electrol Med Nucl. 1978 Dec;59(12):679-87.

PMID:745181
Abstract

The value of different radiological examinations in the diagnosis of left ventricular aneurysms following infarcts is assessed using the results obtained in 36 operated cases. By correlating radiological and surgical findings the orientation value of standard examinations can be determined: almost constant cardiomegaly, irregularity of the borders of the heart, and more rarely, myocardial calcification, are significant signs. The two essential examinations are ventriculography and coronarography. Ventriculography can demonstrate anatomical abnormalities (protrusion), or dynamic changes only (hypokinesia, akinesia, systolic expansion). This remarkably reliable examination showed a predominance of anterior and anterolateral aneurisms (87% of cases), and enables definition of the critical cardiac surface area (about 25%) above which the aneurysm is operable. Coronarography shows that the anterior interventricular artery (A.I.V.) is affected in a large proportion (90%) of aneurysms. These two examinations can be used to select those patients suitable for surgery. Results were good and only one death occurred. In the other cases, the disorders of rhythm were reduced and the manifestations of cardiac insufficiency disappeared.

摘要

利用36例手术病例的结果,评估了不同放射学检查在诊断梗死性左心室动脉瘤中的价值。通过将放射学检查结果与手术结果相关联,可以确定标准检查的定位价值:几乎持续存在的心脏扩大、心脏边界不规则以及较少见的心肌钙化是重要体征。两项基本检查是心室造影和冠状动脉造影。心室造影可以显示解剖学异常(突出)或仅显示动态变化(运动减弱、运动不能、收缩期扩张)。这项非常可靠的检查显示,前壁和前侧壁动脉瘤占优势(87%的病例),并能够确定动脉瘤可手术切除的临界心脏表面积(约25%)。冠状动脉造影显示,大部分动脉瘤(90%)的前室间动脉(A.I.V.)受到影响。这两项检查可用于选择适合手术的患者。结果良好,仅发生1例死亡。在其他病例中,心律失常减轻,心脏功能不全的表现消失。

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