Cabrera A, Velasco J V, Idígoras G, Galdeano J M, Mintegui S, Sánchez J, Pérez P, Pastor E, Cabrera-Zubizarreta A
Servicio de Cardiología Pediátrica, Hospital Infantil de Cruces, Baracaldo, Vizcaya.
Rev Esp Cardiol. 1993 Nov;46(11):721-6.
Evaluation of ventricular septal defect with two-dimensional echocardiography and color flow Doppler.
We had studied by this method 180 patients; 97 males and 83 (mean age 1.5 +/- 1 years) diagnosed of a VSD. Cases with a complex cardiopathy were excluded from the study. The VSD was classified according to its location and relation to the tricuspid anulus and semilunar valves in perimembranous VSD, muscular VSD and subarterial double committed defect. The colour Doppler identified one or two areas of low through the ventricular septum with a zona of proximal acceleration throughout systole. Every group can be evaluated in different views but they all have a selective echocardiographic view except for muscular trabecular VSD.
Seventy-six patients had perimembranous VSD (30 inlet, 26 trabecular and 20 infundibular-outlet), 102 had muscular VSD (3 inlet, 97 trabecular and 2 infundibular-outlet) and 2 had a subarterial double committed defect. A ventricular septal aneurysm was associated in 20 patients with muscular or perimembranous defects. Six patients, 2 of the perimembranous trabecular VSD, 2 muscular-trabecular VSD and 2 subarterial were initially misclassified. In this last 2 cases the turbulence created in the pulmonary valve was wrongly interpreted as pulmonary valvular stenosis; subcostal view for both tracts is necessary to avoid such mistake. In conclusion, color Doppler flow mapping is very useful to differentiate the various types as VSD and aids identification of multiples ventricular septal defects.
应用二维超声心动图和彩色多普勒评估室间隔缺损。
我们采用该方法研究了180例患者；其中97例男性和83例（平均年龄1.5±1岁）被诊断为室间隔缺损。患有复杂心脏病的病例被排除在研究之外。室间隔缺损根据其位置以及与三尖瓣环和半月瓣的关系分为膜周部室间隔缺损、肌部室间隔缺损和动脉下双干下型缺损。彩色多普勒显示在整个收缩期室间隔有一个或两个低流速区域，伴有近端加速区。除肌小梁型室间隔缺损外，每组均可通过不同视图进行评估，但均有一个选择性超声心动图视图。
76例患者为膜周部室间隔缺损（30例流入道型、26例小梁型和20例漏斗部-流出道型），102例为肌部室间隔缺损（3例流入道型、97例小梁型和2例漏斗部-流出道型），2例为动脉下双干下型缺损。20例肌部或膜周部缺损患者合并室间隔瘤。6例患者最初被误诊，其中2例为膜周部小梁型室间隔缺损、2例为肌小梁型室间隔缺损和2例为动脉下型。在最后2例中，肺动脉瓣处产生的湍流被错误地解释为肺动脉瓣狭窄；对于这两种情况，肋下视图是必要的，以避免此类错误。总之，彩色多普勒血流图对于区分不同类型的室间隔缺损非常有用，有助于识别多个室间隔缺损。
