·临床研究·

    作者单位:430022 武汉,华中科技大学同济医学院附属协和医院

    超声影像科

    正常冠状静脉窦的超声心动图初步研究

    朱向明 王新房 谢明星 杨娅 吕清 陈立新 卢晓芳 杨亚利

    【摘要】 目的 运用超声技术检测正常成人冠状静脉窦的形态结构、血流动力学及其在心动周期中的变

    化。方法 选择 46 例健康成人 ,用二维超声多方位显示冠状静脉窦的长、短轴观 ,观察二维灰阶图像特征;用 M

    型超声记录冠状静脉窦内径在心动周期不同时相的变化;用脉冲多普勒记录其血流信号 ,观测频谱形态和流速 ,并通过截面积与速度时间积分的乘积计算冠状静脉窦流量参数。同步记录 Ⅱ导联心电图。结果 心尖非标准

    四腔和心尖两腔观是显示冠状静脉窦灰阶图像的最佳切面观 ,显示率分别为 100 %和 93. 48 %;冠状静脉窦随心

    动周期由心室收缩末期的最大内径(8. 89 ±0. 81) mm ,逐渐缩小到心房收缩末期的最小内径(4. 20 ±0. 53) mm ,内径最大变化率为 52. 67 %±5. 10 %;胸骨旁右室流入道切面观是检测冠状静脉窦血流较为理想的切面 ,检测成

    功率为 43. 48 %,其频谱为双期正向双峰形 ,收缩期流速(Vs) 、舒张期流速(Vd) 、速度时间积分(VTI)和流量参数

    (Q)分别为(42. 30±3. 58) cm/ s、 (37. 50 ±4. 30) cm/ s、 (14. 12 ±1. 21) cm 和(160. 07 ±20. 45) ml/ min。结论 超

    声技术能够较为满意地评价冠状静脉窦的形态结构和血流动力学变化 ,正常冠状静脉窦在心动周期中有收缩和

    舒张性变化 ,其血流频谱类似于下腔静脉频谱 ,可以间接评估冠脉流量。

    【关键词】 超声心动描记术;冠状静脉窦;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

    冠状静脉窦(CS)是冠脉循环回心途径的主要通

    道 ,位于左房室交界的后上方 ,在临床日常超声检查工

    作中常被忽视。有关正常冠状静脉窦的超声系统研究

    的文献报道较少见。近年来 ,在超声检查中发现冠状

    静脉窦在很多先天性和后天性心脏病中发生形态学改

    变才逐渐为人们所重视。本研究运用二维、 M 型和多

    普勒超声技术对冠状静脉窦进行综合评价 ,描述其超

    声心动图特征 ,为认识异常的冠状静脉窦提供基础依

    据。

    资 料 与 方 法

    一、研究对象

    46例健康成人,无先天性及后天性心脏病史,常规

    体检、 X线、心电图及超声心动图检查均正常。男、女各

    23例,年龄19～65 岁,平均(39. 8 ±11. 7)岁。男、女性

    · 354 · 中华超声影像学杂志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.别之间的年龄差异无显著性意义( P = 0. 811) ......