二维超声心动图常用切面及选择

1、二维超声心动图常用切面及选择胸骨旁左室长轴切面(3)正常值：主动脉内径：胸旁左室长轴切面，收缩末期径，环部前后径为1.6-2.6cm ，窦部为2.4-3.9cm，主动脉窦上嵴部为2.1-3.4cm ，升主动脉为2.2-3.4cm，主动脉弓径为2.2-2.7cm。左房内径：前后径收缩末期径、主动脉窦前方垂直间隔 为2.4-3.3cm 。右室内径: 前后径舒张末期径，腱索程度测为2.0cm 以下。左室内径：前后径腱索程度：舒张末期为3.7-5.2cm；收缩末期为2.3-3.6cm。室间隔厚度舒张末期，腱索程度测：( 9.4士0.9 ) mm。左室后壁厚度舒张末期，腱索程度测：( 9.4士0 . 8

2、 ) mm 。胸骨旁左室长轴切面Schematic diagram of the parasternal long-axis view in diastoleshowing the aortic root (Ao), sinotubular junction (STJ), closed right coronary and noncoronary cusps of the aortic valve (RCC and NCC), the open anterior and posterior mitral valve leaflets (AMVL and PMVL), and the left

3、ventricular septum and posterior wall. The medial papillary muscle has been shown for reference, although slight medial angulation is needed to visualize this tructure in the long-axis view. The right ventricular outflow tract (RVOT) is anterior, while the coronary sinus (CS) in the atrioventricular

4、 groove and the descending aorta (DA) are seen posteriorly. The right pulmonary artery (RPA) lies posterior to the ascending aorta. The position of the pericardium is indicated by the thin line. Normal parasternal long-axis 2D echo images at end-diastole (above) and end-systole (below). 解剖图 showing

5、the right ventricle (RV) and atrium (RA),tricuspid valve (TV), and ostia of the coronary sinus (CS) and inferior vena cava (IVC). Schematic and 2D echo images in a right ventricular inflow view(1)正常构造的超声表现：图像左侧，从前向后依次为右室流出道、肺动脉瓣、肺动脉主干及左右肺动脉。中部为右室流出道、主动脉根部、左房。右侧为右室流入道、三尖瓣、右心房 ()此切面选用范围：1)测量主肺动脉及左右肺动脉

6、径，评价肺动脉有无狭窄或扩大。2)测量肺动脉瓣环径，观察肺动脉瓣开、闭运动，评价有无狭窄法洛三联症、四联症等、闭锁肺动脉闭锁、假性共干等。3)观察主、肺动脉的空间位置关系。4)测量右心室流出道内径及前壁厚度，评价有无狭窄扩大及增厚，有无异常构造隔膜、下移的三尖瓣或 肿瘤。 5)观察主动脉瓣叶数目二瓣或多瓣畸 形， 厚度及三个瓣叶的关系及交界处 有无粘连，瓣叶有无狭窄及关闭不全。 6)观察主动脉窦病变主动脉窦瘤或窦瘤 破裂。 7)观察左右冠状动脉开口及主干有无病变 冠状动脉开口异常、扩大、狭窄或闭塞。 8)观察右房大小及三尖瓣有无病变狭 窄、关闭不全、Ebstein 畸形、三尖瓣闭锁。 胸骨旁主

7、动脉根部短轴切面(3) 正常测值：1)右室流出道径自室上嵴至流出道前壁垂直间隔 ；舒张末期为1.9-2.5cm。2)主肺动脉径胸旁主动脉根部短轴切面，瓣上1cm 处：舒张末期为1.5-2.5cm。3)肺动脉瓣环径为1.1-2.2cm ，右肺动脉径0.8-1.6cm ，左肺动脉径l.0-1.4cm。 胸骨旁主动脉根部短轴切面Schematic diagram of a parasternal short-axis view at the aortic valve levelshowing the relationship between the three cusps of the aortic

8、 valve-right coronary cusp (RCC), noncoronary cusp (NCC), left coronary cusp (LCC)-and the left atrium (LA), right atrium (RA), right ventricular outflow tract (RVOT), and the pulmonary artery (PA) with right (RPA) and left (LPA) branches. The positions of the right coronary artery (RCA), left main

9、coronary artery (LMCA), pulmonic valve, and tricuspid valve are shown.Two-dimensional echocardiographic images at the aortic valve level in systole (above) and diastole (below). Note the three open leaflets of the aortic valve in systole and the normal perpendicular relationship of aortic and pulmon

10、ic valves 5胸骨旁腱索程度短轴切面1)正常构造的超声心动图表现：图右侧依次显示左室前壁、侧壁、后壁，中部为室间隔。右前方为右室前壁、右室腔及右室后壁。2)此切面选用范围：测量左室腔径前后及左右径，评价左室大小，观察左室壁厚度及室腔形态正常左室腔呈圆形，腔内显示乳头肌上缘或键索。右室腔大小、位置及形态，有无扩大、转位。3)正常测值：左室横径舒张末期为3.3-5.3cm ，收缩末期为2.4-4.2cm。 Relationship between the short-axis plane with left ventricular wall segments indicated, and

11、the apical four-chamber, two-chamber, and long-axis image planes (perpendicular to the short-axis plane). ()正常解剖构造的超声心动图表现: 图像右侧自上向下依次为左心室、二尖瓣、左房，左侧为右心室、三尖瓣、右房，中央为室间隔、房间隔。()此切面选用范围:1)观察与测量心室及心房大小及形态；2)观察房、室间隔连续情况；3)观察室壁厚度及运动、有无局部运动异常心肌缺血、梗死或膨出室壁瘤；4)观察二尖瓣与三尖瓣数目、形态及开闭情况，测量两隔叶根部附着位置间间隔 Ebstein ) ；5)观察心

12、腔内有无肿物附壁血栓或心内肿瘤及其附着位置、大小、活动情况；6)观察三条左上、左下、右上肺静脉是否均回入左房肺静脉异位引流；7)左心房内有无隔膜三房心；8)评价心功能。 心尖四腔切面(3)正常测值左室长径：舒张末期为7.08.4cm，收缩末期为5.06.4cm 。左房内径：上下径为3.15.3cm 收缩末期，二尖瓣环联线中点至左房顶部，横径为3.05.3cm。收缩末期，心房中部。右室内径：横径为2.54.2cm舒张末期径，长径为5.87.8cm舒张末期径。右房内径为3.44,9cm , 横径为2.94,5cm 心尖四腔切面，收缩末期上下径。 心尖四腔切面Schematic diagram of

13、 the apical four-chamber viewshowing the relationships of the left and right ventricles (LV and RV) and atria (LA and RA). In the left ventricle, the papillary muscle, chordae, and anterior and posterior mitral leaflets (AMVL, PMVL) are seen. The descending aorta (DA) is seen in partial cross sectio

14、n lateral to the left atrium, while the right superior pulmonary vein(RSPV) drains into the left atrium adjacent to the interatrial septum. In the right ventricle, the moderator band (M and the anterior and septal tricuspid valve leaflets (ATVL and STVL) are seen. Note the ventriculoatrial septum (V

15、AS) separating the left ventricle from the right atrium in association with the normal, slightly more apical position of the tricuspid compared with the mitral valve annulus.Two-dimensional echo images in an apical four-chamber view at end-diastole (above) and end-systole (below). 心尖四腔切面心尖四腔切面Subcos

16、tal view showing all four cardiac chambers Schematic and 2D echo images of the aorta in a long-axis view from the suprasternal notch window. The ascending aortic (Ao) arch and descending thoracic aorta are seen with the origins of the left carotid and subclavian arteries. The right pulmonary artery

17、(RPA) lies immediately inferior to the arch. 附：心超常见缩写表 1Abbreviation Definition2-D Two dimensional imaging3-D Three dimensional imagingA-Mode Amplitude modeA Atrial diastolic velocity peakA Area (seen in mathematical formulas)APEX 2C Apical two chamber viewAPEX 3C Apical three chamber view (also kno

18、wn as Apical Long axis)APEX 4C Apical four chamber viewAPEX 5C Apical five chamber viewAcT Acceleration timeAF Atrial fibrillationAMVL Anterior mitral valve leafletAnt AnteriorAo AortaAI Aortic insufficiencyAS Aortic stenosisAsc AscendingASD Atrial septal defectASH Asymmetrical septal hypertrophyATV

19、L Anterior tricuspid valve leafletAV Aortic valveAVA Aortic valve areaAVR Aortic valve replacementBAV Balloon aortic valvuloplastyBP Blood pressureBSA Body surface areac propagation speed of sound in tissue附：心超常见缩写表2dB DecibeldP/dt Rate of change in pressure over timeE EnergyECG ElectrocardiogramED

20、End-diastoleEDD End-diastolic dimensionEDV End-diastolic volumeEF Ejection fractionepi epicardiumEPSS E-point of septal separationES End-systoleESD End-systolic dimensionESPVR End-systolic pressure-volume relationshipESV End-systolic volumeCAD Coronary artery diseasecath Cardiac catheterizationCBV C

21、atheter balloon valvuloplastyCh ChordaeCm Centimetercm/s Centimeter per secondCO Cardiac outputCont eq Continuity equationcos CosineCS Coronary sinusCSA Cross sectional areaCx circumflex coronary arteryD DiameterDA Descending aorta附：心超常见缩写表3ETT Exercise treadmill test Frequency shift FrequencyFL Fal

22、se lumenFn near zoneFo resonance frequency (operating frequency)Fs scattered frequencyFSV forward stroke volumeFt transmitted frequencyFx functionHCM hypertrophic cardiomyopathyHPRF High pulse repetition frequencyHR Heart rateHV Hepatic veinI IntensityIAS Interatrial septuminf inferiorIV intravenous

23、IVC Inferior vena cavaIVCT Isovolumic contraction timeIVRT Isovolumic relaxation timekHz KilohertzL LengthLA Left atriumLAA Left atrial appendageLAD Left anterior descending coronary arteryLAE Left atrial enlargementLAO Left anterior obliquelat LateralLAXX Parasternal long axisLCC Left coronary cusp

24、LLD Left lateral decubitus附：心超常见缩写表4MS Mitral stenosisMV Mitral valve MVA Mitral valve areaMVI Mitral valve insufficiencyMyx myxomaNCC Noncoronary cuspP change in pressureP PressurePA Pulmonary arterypAn PseudoaneurysmPAP Pulmonary artery pressurePD Pulsed DopplerPDA Patent ductus arteriosisPE Peric

25、ardial effusionPEP Pre-ejection periodPISA Proximal isovelocity surface areaLMCA Left main coronary arteryLPA Left pulmonary arteryLSPV left superior pulmonary veinLV Left ventricleLVEDD Left ventricular end diastolic dimensionLV-EDP Left ventricular end diastolic pressureLVESD Left ventricular end

26、systolic dimensionLVH Left ventricular hypertrophyLVI Left ventricular inflowLVO Left ventricular outflowLVOT Left ventricular outflow tractM-mode Motion modeMAC Mitral annular calcificationMB Moderator bandMI Myocardial infarction附：心超常见缩写表5PM papillary musclePMVL Posterior mitral valve leafletpost

27、posteriorPI Pulmonary insufficiencyPRF Pulse repetition frequencyPRFR Peak rapid filling timePS Pulmonary stenosisPV Pulmonic valvePTCA Percutaneous transluminal coronary angioplastyPV Pulmonary veinPVC Premature ventricular contractionPWT Posterior wall thicknessQ Volume flow rateQp Pulmonic volume flow rateQs Systemic volume flow rateRA Right atriumRAE Right atrial enlargementRAO Right anterior obliqueRAP Right atrial pressureRCA Right coronary arteryRCC Right coronary cuspRF Regurgitant fraction