ECHOCARDIOGRAPHIC VISUALIZATION OF CORONARY-ARTERY ANATOMY IN THE ADULT
ECHOCARDIOGRAPHIC VISUALIZATION OF CORONARY-ARTERY ANATOMY IN THE ADULT
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DOI：
10.1016/0735-1097(88)91532-x
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发表时间：
1988-03-01
影响因子：
24
通讯作者：
REICHEK, N
中科院分区：
文献类型：
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作者：
DOUGLAS, PS;FIOLKOSKI, J;REICHEK, N
鉴于技术的进步和新的成像平面的发展，对成人冠状动脉解剖结构的二维超声心动图可视化的可行性进行了重新评估。使用配备3.5和5.0 MHz环形阵列换能器、数字处理和电影回放的超声检查仪对35例受试者进行了研究。正常对照组18例，心脏病组17例，其中瓣膜病9例，冠心病5例，先天性心脏病2例，心肌病1例。平均年龄为47岁。18岁（范围17至79岁）。对标准胸骨旁和心尖视图进行修改，可获得足以评估管腔直径的各主要心外膜血管部分的高质量图像。35例受试者中有30例（86%）可见左冠状动脉主干，15例可见其分叉。在30名受试者中观察到左前降支冠状动脉（平均长度为3.9 ± 1.5 mm）。2.3左回旋支11例（1.1 ±. 1.0，最大3.0）和右冠状动脉32（5.6 ±。2.6，最大12）。左前降支近端和中部分别见于23例和11例受试者。近端平均长度为4.2 cm，平均管腔直径为4.9 mm。左前降支中段平均长度为1.9 cm，平均管腔直径为4.6 mm。17例受试者可见右冠状动脉近端（平均长度为2.7 cm，平均直径为3.1 mm）。在24例受试者中观察到部分右冠状动脉中段（平均长度3.6 cm，平均直径3.1 mm）。在18例受试者中观察到平均2.9 cm的右冠状动脉远端（平均直径2.7 mm）。35例受试者中有11例（31%）可见间隔支或对角支，1例可见边缘分支，所有受试者均可见冠状窦，3例可见较小静脉。 5例受试者中有4例正确识别出冠状动脉病变（2例在左前降支，1例在左主干，1例在右冠状动脉），但1例受试者的冠状动脉病变被钙化的主动脉瓣掩盖。改进的仪器与新的成像技术相结合，允许成人冠状动脉血管的广泛可视化。这项技术在冠状动脉疾病无创评估中的临床应用仍有待确定。
In the light of technologic advances and the development of new imaging planes, the feasibility of two-dimensional echocardiographic visualization of coronary artery anatomy was reevaluated in the adult. Thirty-five subjects were studied using an ultrasonograph equipped with a 3.5 and 5.0 MHz annular array transducer, digital processing and cine loop review. Thee was 18 normal subjects and 17 patients with heart disease, including 9 patients with valvular, 5 patients with coronary, 2 patients with congenital and 1 patient with cardiomyopathic disease. The mean age was 47 .+-. 18 years (range 17 to 79). Modifications of standard parasternal and apical views permitted high quality images of portions of each of the major epicardial vessels adequate for assessment of luminal diameter. The left main coronary artery was seen in 30 (86%) of the 35 subjects and its bifurcation was seen in 15. The left anterior descending coronary artery was seen in 30 subjects (mean length 3.9 .+-. 2.3 cm, maximal length 7.5), the left circumflex artery in 11 (1.1 .+-. 1.0, maximal 3.0) and the right coronary artery in 32 (5.6 .+-. 2.6, maximal 12). Proximal and mid portions of the left anterior descending artery were seen in 23 and 11 subjects, respectively. The average proximal length visualized was 4.2 cm, and the average luminal diameter visualized was 4.9 mm. The average length of the mid left anterior descending coronary artery seen was 1.9 cm and the average luminal diameter seen was 4.6 mm. The proximal right coronary artery was seen in 17 subjects (average visualized length 2.7 cm and average diameter 3.1 mm). Portions of the mid right coronary artery were seen in 24 subjects (average length 3.6 cm and average diameter 3.1 mm). An average of 2.9 cm of the distal right coronary artery was seen in 18 subjects (average diameter 2.7 mm). Septal or diagonal branches were seen in 11 (31%) of the 35 subjects, a marginal branch in 1, the coronary sinus in all and smaller veins in 3. Coronary artery lesions were correctly identified in four of five subjects (two in the left anterior descending, one in the left main and one in the right coronary artery), but these were obscured in one subject by a calcified aortic valve. Improved instrumentation combined with new imaging techniques permits extensive visualization of the adult coronary vasculature. The clinical utility of this technique for the noninvasive evaluation of coronary artery diseae remains to be determined.