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·臨床研究·
作者單位:430022 武漢,華中科技大學(xué)同濟醫(yī)學(xué)院附屬協(xié)和醫(yī)院
超聲影像科
正常冠狀靜脈竇的超聲心動圖初步研究
朱向明 王新房 謝明星 楊婭 呂清 陳立新 盧曉芳 楊亞利
【摘要】 目的 運用超聲技術(shù)檢測正常成人冠狀靜脈竇的形態(tài)結(jié)構(gòu)、血流動力學(xué)及其在心動周期中的變
化。方法 選擇 46 例健康成人 ,用二維超聲多方位顯示冠狀靜脈竇的長、短軸觀 ,觀察二維灰階圖像特征;用 M
型超聲記錄冠狀靜脈竇內(nèi)徑在心動周期不同時相的變化;用脈沖多普勒記錄其血流信號 ,觀測頻譜形態(tài)和流速 ,并通過截面積與速度時間積分的乘積計算冠狀靜脈竇流量參數(shù)。同步記錄 Ⅱ?qū)?lián)心電圖。結(jié)果 心尖非標(biāo)準(zhǔn)
四腔和心尖兩腔觀是顯示冠狀靜脈竇灰階圖像的最佳切面觀 ,顯示率分別為 100 %和 93. 48 %;冠狀靜脈竇隨心
動周期由心室收縮末期的最大內(nèi)徑(8. 89 ±0. 81) mm ,逐漸縮小到心房收縮末期的最小內(nèi)徑(4. 20 ±0. 53) mm ,內(nèi)徑最大變化率為 52. 67 %±5. 10 %;胸骨旁右室流入道切面觀是檢測冠狀靜脈竇血流較為理想的切面 ,檢測成
功率為 43. 48 %,其頻譜為雙期正向雙峰形 ,收縮期流速(Vs) 、舒張期流速(Vd) 、速度時間積分(VTI)和流量參數(shù)
(Q)分別為(42. 30±3. 58) cm/ s、 (37. 50 ±4. 30) cm/ s、 (14. 12 ±1. 21) cm 和(160. 07 ±20. 45) ml/ min。結(jié)論 超
聲技術(shù)能夠較為滿意地評價冠狀靜脈竇的形態(tài)結(jié)構(gòu)和血流動力學(xué)變化 ,正常冠狀靜脈竇在心動周期中有收縮和
舒張性變化 ,其血流頻譜類似于下腔靜脈頻譜 ,可以間接評估冠脈流量。
【關(guān)鍵詞】 超聲心動描記術(shù);冠狀靜脈竇;成年人
Echocardiographic evaluation of coronary sinus in healthy adults ZHU Xiangming , WA N G Xinf ang , XI E
Mingxing , et al . Department of Ul t rasonography , Union Hospital of Tongji Medical College , Huaz hong University of
Science and Technology , Wuhan 430022 , China
【Abst ract】 Objective To evaluate the shape ,size and hemodynamics of coronary sinus (CS) ,and their changes
during a cardiac cycle by echocardiography. Methods Fourty2six healthy adults were elected randomly and studied.
Long 2axis and short2axis pictures of CS were dis played by two2dimensional echocardiography. Change of CS caliber
during a cardiac cycle was recorded with M2mode echocardiography. Blood flow of CS was studied by pulsed wave
Doppler. Results Apical nonstandard four2chamber and two2chamber views were optimal planes for showing CS in 46
of 46 (100 %) and in 43 of 46 subjects (93. 48 %) ,respectively. CS caliber dilated up to the maximum (8. 89 ±0. 81)
mm at end 2systolic period of vent ricular (at end of T2wave) and narrowed gradually hereafter ,to the miximum (4. 20 ±
0. 53) mm at end 2systolic period of at rium (just at peak of R2wave) . Average percentage of change in CS caliber during
a cardiac cycle was 52. 67 %±5. 10 %. Parasternal right vent ricular inflow view was bet ter for recording CS flow in 22
of 46 adults (43. 48 %) . Flow pat tern in CS consisted of a positive two2peak spect rum with a systolic and a diastolic
phases. Velocity in systolic (Vs) and diastolic periods (Vd) ,velocity2time intergral (VTI) ,and flow quantity (Q) were
(42. 30 ±3. 58) cm/ s , ( 37. 50 ±4. 30) cm/ s , ( 14. 12 ±1. 21) cm and ( 160. 07 ±20. 45) ml/ min , respectively.
Conclusions Normal CS has its own diastolic and systolic changes during a cardiac cycle and CS flow pat tern is similar
to that in the inferior vena cava. Coronary blood flow may be estimated indirectly with two dimensional ,M2mode and
pulsed2wave Doppler echocardiography.
【Key words】 Echocardiography ;Coronary sinus ;Adult
冠狀靜脈竇(CS)是冠脈循環(huán)回心途徑的主要通
道 ,位于左房室交界的后上方 ,在臨床日常超聲檢查工
作中常被忽視。有關(guān)正常冠狀靜脈竇的超聲系統(tǒng)研究
的文獻報道較少見。近年來 ,在超聲檢查中發(fā)現(xiàn)冠狀
靜脈竇在很多先天性和后天性心臟病中發(fā)生形態(tài)學(xué)改
變才逐漸為人們所重視。本研究運用二維、 M 型和多
普勒超聲技術(shù)對冠狀靜脈竇進行綜合評價 ,描述其超
聲心動圖特征 ,為認識異常的冠狀靜脈竇提供基礎(chǔ)依
據(jù)。
資 料 與 方 法
一、研究對象
46例健康成人,無先天性及后天性心臟病史,常規(guī)
體檢、 X線、心電圖及超聲心動圖檢查均正常。男、女各
23例,年齡19～65 歲,平均(39. 8 ±11. 7)歲。男、女性
· 354 · 中華超聲影像學(xué)雜志2002 年8 月第11 卷第8 期 Chin J Ult rasonogr ,August 2002 ,Vol 11 ,No. 8
? 1995-2005 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved.別之間的年齡差異無顯著性意義( P = 0. 811) ......
作者單位:430022 武漢,華中科技大學(xué)同濟醫(yī)學(xué)院附屬協(xié)和醫(yī)院
超聲影像科
正常冠狀靜脈竇的超聲心動圖初步研究
朱向明 王新房 謝明星 楊婭 呂清 陳立新 盧曉芳 楊亞利
【摘要】 目的 運用超聲技術(shù)檢測正常成人冠狀靜脈竇的形態(tài)結(jié)構(gòu)、血流動力學(xué)及其在心動周期中的變
化。方法 選擇 46 例健康成人 ,用二維超聲多方位顯示冠狀靜脈竇的長、短軸觀 ,觀察二維灰階圖像特征;用 M
型超聲記錄冠狀靜脈竇內(nèi)徑在心動周期不同時相的變化;用脈沖多普勒記錄其血流信號 ,觀測頻譜形態(tài)和流速 ,并通過截面積與速度時間積分的乘積計算冠狀靜脈竇流量參數(shù)。同步記錄 Ⅱ?qū)?lián)心電圖。結(jié)果 心尖非標(biāo)準(zhǔn)
四腔和心尖兩腔觀是顯示冠狀靜脈竇灰階圖像的最佳切面觀 ,顯示率分別為 100 %和 93. 48 %;冠狀靜脈竇隨心
動周期由心室收縮末期的最大內(nèi)徑(8. 89 ±0. 81) mm ,逐漸縮小到心房收縮末期的最小內(nèi)徑(4. 20 ±0. 53) mm ,內(nèi)徑最大變化率為 52. 67 %±5. 10 %;胸骨旁右室流入道切面觀是檢測冠狀靜脈竇血流較為理想的切面 ,檢測成
功率為 43. 48 %,其頻譜為雙期正向雙峰形 ,收縮期流速(Vs) 、舒張期流速(Vd) 、速度時間積分(VTI)和流量參數(shù)
(Q)分別為(42. 30±3. 58) cm/ s、 (37. 50 ±4. 30) cm/ s、 (14. 12 ±1. 21) cm 和(160. 07 ±20. 45) ml/ min。結(jié)論 超
聲技術(shù)能夠較為滿意地評價冠狀靜脈竇的形態(tài)結(jié)構(gòu)和血流動力學(xué)變化 ,正常冠狀靜脈竇在心動周期中有收縮和
舒張性變化 ,其血流頻譜類似于下腔靜脈頻譜 ,可以間接評估冠脈流量。
【關(guān)鍵詞】 超聲心動描記術(shù);冠狀靜脈竇;成年人
Echocardiographic evaluation of coronary sinus in healthy adults ZHU Xiangming , WA N G Xinf ang , XI E
Mingxing , et al . Department of Ul t rasonography , Union Hospital of Tongji Medical College , Huaz hong University of
Science and Technology , Wuhan 430022 , China
【Abst ract】 Objective To evaluate the shape ,size and hemodynamics of coronary sinus (CS) ,and their changes
during a cardiac cycle by echocardiography. Methods Fourty2six healthy adults were elected randomly and studied.
Long 2axis and short2axis pictures of CS were dis played by two2dimensional echocardiography. Change of CS caliber
during a cardiac cycle was recorded with M2mode echocardiography. Blood flow of CS was studied by pulsed wave
Doppler. Results Apical nonstandard four2chamber and two2chamber views were optimal planes for showing CS in 46
of 46 (100 %) and in 43 of 46 subjects (93. 48 %) ,respectively. CS caliber dilated up to the maximum (8. 89 ±0. 81)
mm at end 2systolic period of vent ricular (at end of T2wave) and narrowed gradually hereafter ,to the miximum (4. 20 ±
0. 53) mm at end 2systolic period of at rium (just at peak of R2wave) . Average percentage of change in CS caliber during
a cardiac cycle was 52. 67 %±5. 10 %. Parasternal right vent ricular inflow view was bet ter for recording CS flow in 22
of 46 adults (43. 48 %) . Flow pat tern in CS consisted of a positive two2peak spect rum with a systolic and a diastolic
phases. Velocity in systolic (Vs) and diastolic periods (Vd) ,velocity2time intergral (VTI) ,and flow quantity (Q) were
(42. 30 ±3. 58) cm/ s , ( 37. 50 ±4. 30) cm/ s , ( 14. 12 ±1. 21) cm and ( 160. 07 ±20. 45) ml/ min , respectively.
Conclusions Normal CS has its own diastolic and systolic changes during a cardiac cycle and CS flow pat tern is similar
to that in the inferior vena cava. Coronary blood flow may be estimated indirectly with two dimensional ,M2mode and
pulsed2wave Doppler echocardiography.
【Key words】 Echocardiography ;Coronary sinus ;Adult
冠狀靜脈竇(CS)是冠脈循環(huán)回心途徑的主要通
道 ,位于左房室交界的后上方 ,在臨床日常超聲檢查工
作中常被忽視。有關(guān)正常冠狀靜脈竇的超聲系統(tǒng)研究
的文獻報道較少見。近年來 ,在超聲檢查中發(fā)現(xiàn)冠狀
靜脈竇在很多先天性和后天性心臟病中發(fā)生形態(tài)學(xué)改
變才逐漸為人們所重視。本研究運用二維、 M 型和多
普勒超聲技術(shù)對冠狀靜脈竇進行綜合評價 ,描述其超
聲心動圖特征 ,為認識異常的冠狀靜脈竇提供基礎(chǔ)依
據(jù)。
資 料 與 方 法
一、研究對象
46例健康成人,無先天性及后天性心臟病史,常規(guī)
體檢、 X線、心電圖及超聲心動圖檢查均正常。男、女各
23例,年齡19～65 歲,平均(39. 8 ±11. 7)歲。男、女性
· 354 · 中華超聲影像學(xué)雜志2002 年8 月第11 卷第8 期 Chin J Ult rasonogr ,August 2002 ,Vol 11 ,No. 8
? 1995-2005 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved.別之間的年齡差異無顯著性意義( P = 0. 811) ......
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