Ultrasound diagnosis of cardiovascular disease

Doppler echocardiography can be used to analyze the trajectory of high-speed motion, blood flow direction, and blood flow properties of heart wall thickness, velocity, amplitude, slope, and valve. Cut surface (two-dimensional) echocardiography to measure normal values: the inner diameter of the heart chamber and the large blood vessels are both the starting and ending points at the two sides of the liquid dark area (excluding the width of the reflected light band between the heart wall and the blood interface), using electrons The vernier scale is measured directly on the screen, or the image is enlarged and then calculated using a common ruler. Unit: mm. When measuring the long diameter of the ventricle (or atrium), one end is at the apex (or the top of the atrium) and the other end is at the midpoint of the attachment at both sides of the atrioventricular valve. When measuring the transverse diameter and the anteroposterior diameter, the longest connection line equal to the angle between the two sides of the heart wall (or the vessel wall) should be taken. In terms of phase selection, the T-wave peak of the ECG is taken at the end of the contraction. At the end of diastole, the peak of the R wave is taken. Basic Information Specialist classification: cardiovascular examination classification: ultrasound Applicable gender: whether men and women apply fasting: not fasting Tips: Do not exercise vigorously before checking. Normal value 1. Sectional (two-dimensional) echocardiography measures the normal value of the inner diameter of the heart chamber and the large blood vessels. The edge of both sides of the liquid dark area is the starting and ending point (excluding the width of the reflected light band between the heart wall and the blood). The electronic vernier scale is measured directly on the screen, or the image is enlarged and then calculated using a common ruler. Unit mm. When measuring the long diameter of the ventricle (or atrium), one end is at the apex (or the top of the atrium) and the other end is at the midpoint of the attachment at both sides of the atrioventricular valve. When measuring the transverse diameter and the anteroposterior diameter, the longest connection line equal to the angle between the two sides of the heart wall (or the vessel wall) should be taken. In terms of phase selection, the T-wave peak of the ECG is taken at the end of the contraction. At the end of diastole, the peak of the R wave is taken. 1 left ventricular left ventricular long axis cut front and rear diameter (D) 56.98 ± 3.88; anteroposterior diameter (S) 34.31 ± 3.48; mitral horizontal anteroposterior diameter (D), male 52.1 ± 2.0; female 49.6 ± 1.6; short axis cut before and after Path (S), male 34.7 ± 3.9; female 32.7 ± 4.1; apical four-chamber transverse diameter (D), male 47.0 ± 3.6; female 41.0 ± 6.3; transverse diameter (S) male 36.5 ± 3.7; female 32.4 ± 5.0; The apical two-chamber long diameter (D) is 81.21±7.48; the long diameter (S) is 56.21±9.28. 2 right ventricular left ventricular long axis cut front and rear diameter (D), male 21.2 ± 3.8; female 18.8 ± 2.2; anteroposterior diameter (S), male 21.0 ± 3.9; female 19.1 ± 4.0; apical four-cavity long diameter (D), Male 66.2±10.4; female 62.9±8.3; long diameter (S), male 50.2±9.1; female 46.1±7.5; transverse diameter (D), male 27.9±5.4; female 21.6±6.1 transverse diameter (S), male 22.0± 5.6; female 16.9 ± 5.1. 3 left atrial left ventricular long axis dense front and rear diameter (S), male 28.9 ± 4.3; female 28.1 ± 3.9; apical four-cavity long diameter (D), male 33.4 ± 8.8; female 32.6 ± 8.6; long diameter (S ), male 44.0 ± 9.1; female 3.0 ± 6.3; transverse diameter (D), male 5.8 ± 6.4; female 3.1 ± 5.0; transverse diameter (S), male 31.7 ± 3.6; female 30.5 ± 5.1. 4 right apex apical four-cavity long diameter (D), male 34.7 ± 5.9; female 30.6 ± 4.4; long diameter (S), male 46.4 ± 4.9; female 43.5 ± 4.7; transverse diameter (D), male 33.9 ± 5.8 Female 22.9 ± 4.6; transverse diameter (S), male 35.8 ± 5.7; female 31.9 ± 6.9. 5 The aortic root anteroposterior diameter was 24.00±2.45; the aortic arch transverse diameter was 24.00±2.85; the abdominal aorta posterior diameter was 17.79±2.81; the abdominal aorta middle anteroposterior diameter was 17.68±1.22. 6 The pulmonary artery had a short-axis tangential annulus at the base of the heart, with a transverse diameter of 20.23±2.9; at the widest point, the transverse diameter was 22.5±2.5. 7 inferior vena cava inferior vena cava long axis cut front and rear diameter (suck) 11.34 ± 3.94; anteroposterior diameter (call) 18.75 ± 3.92. The anteroposterior diameter of the bilateral neck of the common carotid artery was 7.68±0.68 for males and 7.00±0.71 for females. 9 left coronary artery trunk left heart short axis cut front and rear diameter 4.70 ± 1.37. 2. The thickness is selected to be measured at the interface on both sides of the heart wall, and the vertical distance between them is the thickness of the core wall of the area (including the width of the edge strip). Units in millimeters. 1 room interval mitral valve horizontal short axis cut front and rear diameter (D): 9.4 ± 0.9. 2 left ventricular posterior wall mitral valve horizontal short axis cut front and rear diameter (D): 9.0 ± 0.8. 3. Distance refers to the length between two points on the cut surface. Units in millimeters. Taking the distance between the anterior mitral lobes and the tricuspid lobes as an example, the statistical values ​​are as follows: apical four-chamber map: distance: total: 9.51 ± 0.73. 4. Area refers to the size of the contour of the ring structure on the cut surface, which can be calculated by computer or mechanical method. When measuring the area of ​​the liquid dark area, the light band around it is not included. Unit cm 2. Taking the area of ​​the mitral valve orifice as an example, it should be measured after freezing at the maximum opening of the diastolic zone. Mitral regurgitation short axis section: area: total: 5.4871 ± 1.092. 5. Capacity Assume that the heart chamber is an ellipse or a cone, and the volume is derived from its long axis, short axis, and/or area. Units of millimeters, with the left ventricle as an example, have two sets of measurements. Apical two-cavity map (single-sided ellipse formula) diastolic phase: total: 108.86±24.39; total systolic period 45.60±16.68; total stroke volume 64.67±17.44; total ejection fraction 60.08±10.66%; left ventricular volume index Volume divided by body surface area in cc/m2. Multiple sections (modified Simpson method) total relaxation of 69.0 ± 6.3; total systolic 22.5 ± 4.2; stroke index total 46.5 ± 4.8; total ejection fraction of 67.5 ± 4.7%. Clinical significance Abnormal result 1. M-mode echocardiography can be used to analyze the trajectory of high-speed motion such as heart wall thickness, motion velocity, amplitude, slope and valve. Due to the small amount of information of the single-beam detection structure, it is difficult to fully display the changes in the structure of the heart and the spatial adjacency. With the wide application of two-dimensional echocardiography and other new methods, M echocardiography is no longer used alone in the ultrasound diagnosis of modern cardiovascular disease, but it can still be used as an important auxiliary diagnostic method for a wide range of applications. 2, two-dimensional echocardiography is the basis for the development of various types of echocardiography, ultrasound contrast, transesophageal ultrasound should be based on two-dimensional echocardiography. It can display the fault structure, adjacent relationship and dynamic changes of different locations of the great vessels of the heart from two-dimensional space. It is the core examination method of cardiac ultrasound and is suitable for the examination of various types of cardiovascular diseases. 3, contrast echocardiography (also known as acoustic contrast) 1 can determine the right to left shunt and shunt level; 2 negative contrast area can be judged from left to right shunt, its accuracy rate of up to 90%. 4, Doppler echocardiography can be used to measure blood flow direction, blood flow properties, blood flow velocity, blood flow, abnormal blood flow, abnormal blood flow can assist two-dimensional echocardiography, clear structural abnormalities And go, determine the abnormal shunt phase. 5. Stress echocardiography provides a non-invasive method for clinicians to evaluate myocardial perfusion and left ventricular function. It can detect heart disease patients with maximal stimulation of myocardial aerobics under load, pacing, grip strength, and drug loading. The myocardial ischemia was induced, and the wall motion and hemodynamic changes were recorded immediately, so that the degree of heart disease and the compensatory function (reserve function) were quantitatively evaluated. 6. Transesophageal echocardiography (TEE) is a new cardiovascular ultrasound technology developed in recent years. Because of its special exploration position and high-quality image display, it has opened up a new window for cardiac angiography and expanded transthoracic The scope of ultrasound examination makes up for the deficiency of TEE, so it is gradually widely used in clinical practice. Scope of application: 1, abnormal cardiac structure, such as structural defects, increase, thickening, stenosis, widening, cracking, etc., artificial valve function evaluation. 2. Abnormal judgment of the relationship between the heart structure, such as the abnormality and dislocation of the vein and the atrium, the atrium and the ventricle, and the connection between the ventricle and the aorta. 3, myocardial function and pump function. 4, cardiac hemodynamic changes, such as flow rate, pressure, flow, with or without abnormal flow and other observations. People who need to be tested: People with palpitations, difficulty breathing, cyanosis, dizziness, syncope and other symptoms. High results may be diseases: young and middle-aged cerebral infarction, pediatric hypertrophic cardiomyopathy, myocardial ischemia, cardiac rhabdomyomas, primary pulmonary hypertension, mental disorders associated with cardiovascular disease Before the test: Do not exercise vigorously. Inspection process Intubation method: The esophageal ultrasound probe is routinely disinfected according to the gastroscope sterilization method. The front end of the probe is coated with a lubricant of about 150°, and the patient bites the dental pad. The surgeon quickly inserts the probe into the esophagus through the oral cavity to the pharynx. The multi-plane probe automatically scans continuously from 0-180° through the button on the probe handle. 1, the bottom of the heart: the probe is about 25-30cm from the incisor to find the bottom of the heart, according to the degree of the angle of the probe, can show the short axis of the aortic root, ascending aorta, aortic valve, long axis of the pulmonary artery (main pulmonary artery, Pulmonary bifurcation, left and right pulmonary artery), pulmonary valve, pulmonary vein, right ventricular outflow tract, left atrial appendage, atrial septum, etc. 2, four-cardiogram sectional view: increase the insertion depth of the esophageal probe, can show a similar view of the four-heart cavity of the sternum, as well as the coronary sinus, inferior vena cava, left ventricular outflow tract to aortic valve. 3, left ventricle short-axis cross-sectional view: the probe continues to insert to the level of the bottom of the stomach, can show the left ventricle short-axis cross-sectional view, observed left ventricular mitral papillary muscle, right ventricular oblique section, thoracic aorta. Not suitable for the crowd Inappropriate people: Generally there are no people who are not suitable. Adverse reactions and risks Generally no adverse reactions.

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