三心房症雙相弧型超音波心圖圖型：四病例報告

Use of Two-Dimensional Echocardiograms in Four Cases of Cor Triatriatum

柯文良(Wun-Liang Ke) ； 王南焜(Nan-Koong Wang) ； 沈慶村(Ching-Tsuen Shen) ； 林永明(Yung-Ming Lin) ； 陳瑞雄(Thay-Hsiung Chen) ； 蔡朝仁(Chaur-Ren Tsai)

《Acta Paediatrica Sinica》 28卷3期 (1987/06) Pp. 189-195

摘要

三心房症是一種罕見的先天性心臟異常；得統上，經由心導管及心臟血管造影檢查，有一半在左心房腔內有一不正常的膈膜，而確證其診斷。本院從1984年到1985年曾有4例三心房症接受雙相超音波心圖檢查。超音波心圖的檢查切面包括左胸骨旁心長軸面，心短軸面，心尖四房室面及劍突下四房室面，結果發現左心房內有一不正常膈膜，而膈膜上有狹窄開口；在左胸骨旁心短軸面轉向四房室影像面，或劍突下四房室影像面更向前至主動脈瓣影像面時，可見到左心耳在此不正常膈膜下方，故可診斷此為三心房症，而可與全肺靜脈回流異常及僧帽瓣上環之病例鑑別。故雙相心臟超音波檢查對三心房症之診斷是一種非侵犯性且能相當正確之檢查方法。

並列摘要

Cor triatriatum (CT) is a rare congenital heart disease. Two-dimensional (2-D) echocardiograms reveal an abnormal membrane located within the left atrium; the medial insertion is at the mid-portion of the interatrial septum, and the lateral insertion is at the middle portion of the lateral atrial wall. The upper proximal chamber receives pulmonary venous drainage and the lower distal chamber contains the left atrial appendage and mitral valve inlet.
In these 2-D echo studies of four cases of CT, the abnormal membrane could be detected at long and short axial parasternal views (LPS, SPS), as well as at apical and subxyphoid four-chamber views (A4C, S4C). From the long axial view, the abnormal membrane was located superior and parallel a short distance behind the aortic root, creating a superior recess in the distal left atrial chamber. From short axial view, the abnormal membrane was located a short distance behind the aortic valve, the left atrial appendage appeared anterior and inferior to the abnormal membrane when the transducer was rotated to a short parasternal four-chamber view. In the apical or subxyphoid four-chamber view, the insertion of the abnormal membrane was more superior in position and was arched in appearance within the left atrium, moving toward the mitral valve funnel during diastole. The left atrium appendage, located anteriorly and inferiorly to the abnormal membrane, could be demonstrated by rotating the transducer from subxyphoid four-chamber view toward the anterior.
Visualization of the left atrial appendage below the abnormal membrane can differentiate cor triatriatum from supravalvar mitral ring and the coronary sinus type of total abnormal pulmonary venous drainage. In conclusion, 2-D echo is a noninvasive and accurate method for diagnosis of cor triatriatum.

並列關鍵字

cortriatriatum ； two-dimensional echocardiography ； abnormal membrane