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簡介：1胸骨旁左室長軸切面,1正常解剖結(jié)構(gòu)的超聲表現(xiàn)心底部自前向后分別為右室流出道、主動脈根部及左心房，正常三者內(nèi)徑基本相同。中部由前向后依次為右室前壁、右室流出道、室間隔、左室流出道、左室流入道二尖瓣前、后葉及腱索。心尖部自前向后依次為室間隔、左室腔及左室后壁。2選用范圍1右主流出道評價右窒流出道有無狹窄、擴大等。2主動脈根部；評價主動脈根都病變，包括有無管壁增厚、夾層，管腔擴大、狹窄竇部擴大、瘤樣膨出或破口瓣葉右及無冠瓣增厚、纖維化或鈣化、贅生物、脫垂、梿枷樣運動、開放受限或關(guān)團不全等，并可分別測量瓣環(huán)、竇部、嵴部及開主動脈徑，3左心房；觀察并測量左心房大小、左房內(nèi)有無血栓、腫瘤、隔膜、左房下后方冠狀靜脈竇有無擴大，后方異常管道結(jié)構(gòu)肺總靜脈。4右室前壁；評價右室前壁有無液區(qū)心包積液，心室壁有無增厚、右室腔大小。5室間隔測量室間隔厚度肥厚或變薄及運動幅度減弱或不運動、回聲室間隔中都連續(xù)中斷肌部間隔缺損，上部與主動脈前壁連續(xù)中斷膜周或嵴下型室間隔缺損，主動脈騎跨于室間隔上法洛四聯(lián)癥或永存動脈干，心尖部室間隔連續(xù)中斷室壁穿孔等。6左室腔及左室后壁測心腔大小、后壁厚度及運動幅度、觀察心腔形態(tài)，有無心尖圓鈍擴大、室壁膨出室壁瘤及附壁血栓等。7二尖瓣及瓣器；觀察二尖瓣葉的厚度、回聲強度彈性、開閉活動、有無增厚、鈣化、贅生物等異常，鍵索有無增厚、粘附著于室間隔等，二尖瓣前葉根部與主脈后壁的纖維連續(xù)是否正常，有無肌性連續(xù)（右室雙出口、大血管轉(zhuǎn)位）。,胸骨旁左室長軸切面,3正常值①主動脈內(nèi)徑胸旁左室長軸切面，收縮末期徑，環(huán)部前后徑為1626CM，竇部為2439CM，主動脈竇上（嵴部）為2134CM，升主動脈為2234CM，主動脈弓徑為2227CM。②左房內(nèi)徑前后徑（收縮末期徑、主動脈竇后方垂直距離）為2433CM。,③右室內(nèi)徑前后徑（舒張末期徑，腱索水平測）為20CM以下。④左室內(nèi)徑前后徑（腱索水平）舒張末期為3752CM；收縮末期為2336CM。⑤室間隔厚度（舒張末期，腱索水平測）94士09MM。⑥左室后壁厚度（舒張末期，腱索水平測）94士08MM。,胸骨旁左室長軸切面SCHEMATICDIAGRAMOFTHEPARASTERNALLONGAXISVIEWINDIASTOLE,SHOWINGTHEAORTICROOTAO,SINOTUBULARJUNCTIONSTJ,CLOSEDRIGHTCORONARYANDNONCORONARYCUSPSOFTHEAORTICVALVERCCANDNCC,THEOPENANTERIORANDPOSTERIORMITRALVALVELEAFLETSAMVLANDPMVL,ANDTHELEFTVENTRICULARSEPTUMANDPOSTERIORWALLTHEMEDIALPAPILLARYMUSCLEHASBEENSHOWNFORREFERENCE,ALTHOUGHSLIGHTMEDIALANGULATIONISNEEDEDTOVISUALIZETHISTRUCTUREINTHELONGAXISVIEWTHERIGHTVENTRICULAROUTFLOWTRACTRVOTISANTERIOR,WHILETHECORONARYSINUSCSINTHEATRIOVENTRICULARGROOVEANDTHEDESCENDINGAORTADAARESEENPOSTERIORLYTHERIGHTPULMONARYARTERYRPALIESPOSTERIORTOTHEASCENDINGAORTATHEPOSITIONOFTHEPERICARDIUMISINDICATEDBYTHETHINLINENORMALPARASTERNALLONGAXIS2DECHOIMAGESATENDDIASTOLEABOVEANDENDSYSTOLEBELOW,2右室流出道切面,解剖圖,3右室流入道切面,SHOWINGTHERIGHTVENTRICLERVANDATRIUMRA,TRICUSPIDVALVETV,ANDOSTIAOFTHECORONARYSINUSCSANDINFERIORVENACAVAIVC,SCHEMATICAND2DECHOIMAGESINARIGHTVENTRICULARINFLOWVIEW,,4胸骨旁主動脈根部短軸切面,1正常結(jié)構(gòu)的超聲表現(xiàn)圖像左側(cè)，從前向后依次為右室流出道、肺動脈瓣、肺動脈主干及左右肺動脈。中部為右室流出道、主動脈根部、左房。右側(cè)為右室流入道、三尖瓣、右心房,２此切面選用范圍1測量主肺動脈及左右肺動脈徑，評價肺動脈有無狹窄或擴大。2測量肺動脈瓣環(huán)徑，觀察肺動脈瓣開、閉運動，評價有無狹窄（法洛三聯(lián)癥、四聯(lián)癥等）、閉鎖（肺動脈閉鎖、假性共干等）。3觀察主、肺動脈的空間位置關(guān)系。4測量右心室流出道內(nèi)徑及前壁厚度，評價有無狹窄擴大及增厚，有無異常結(jié)構(gòu)（隔膜、下移的三尖瓣或腫瘤）。5觀察主動脈瓣葉數(shù)目（二瓣或多瓣畸形），厚度及三個瓣葉的關(guān)系及交界處有無粘連，瓣葉有無狹窄及關(guān)閉不全。6觀察主動脈竇病變（主動脈竇瘤或竇瘤破裂）。7觀察左右冠狀動脈開口及主干有無病變（冠狀動脈開口異常、擴大、狹窄或閉塞）。8觀察右房大小及三尖瓣有無病變（狹窄、關(guān)閉不全、EBSTEIN畸形、三尖瓣閉鎖）。,胸骨旁主動脈根部短軸切面,3正常測值1右室流出道徑（自室上嵴至流出道前壁垂直距離）；舒張末期為1925CM。2主肺動脈徑（胸旁主動脈根部短軸切面，瓣上1CM處）舒張末期為1525CM。3肺動脈瓣環(huán)徑為1122CM，右肺動脈徑0816CM，左肺動脈徑L014CM。,胸骨旁主動脈根部短軸切面SCHEMATICDIAGRAMOFAPARASTERNALSHORTAXISVIEWATTHEAORTICVALVELEVEL,SHOWINGTHERELATIONSHIPBETWEENTHETHREECUSPSOFTHEAORTICVALVERIGHTCORONARYCUSPRCC,NONCORONARYCUSPNCC,LEFTCORONARYCUSPLCCANDTHELEFTATRIUMLA,RIGHTATRIUMRA,RIGHTVENTRICULAROUTFLOWTRACTRVOT,ANDTHEPULMONARYARTERYPAWITHRIGHTRPAANDLEFTLPABRANCHESTHEPOSITIONSOFTHERIGHTCORONARYARTERYRCA,LEFTMAINCORONARYARTERYLMCA,PULMONICVALVE,ANDTRICUSPIDVALVEARESHOWNTWODIMENSIONALECHOCARDIOGRAPHICIMAGESATTHEAORTICVALVELEVELINSYSTOLEABOVEANDDIASTOLEBELOWNOTETHETHREEOPENLEAFLETSOFTHEAORTICVALVEINSYSTOLEANDTHENORMALPERPENDICULARRELATIONSHIPOFAORTICANDPULMONICVALVES,,5．胸骨旁腱索水平短軸切面,1正常結(jié)構(gòu)的超聲心動圖表現(xiàn)圖右側(cè)依次顯示左室前壁、側(cè)壁、后壁，中部為室間隔。右前方為右室前壁、右室腔及右室后壁。,2此切面選用范圍①測量左室腔徑（前后及左右徑），評價左室大小，觀察左室壁厚度及室腔形態(tài)（正常左室腔呈圓形），腔內(nèi)顯示乳頭肌上緣或鍵索。②右室腔大小、位置及形態(tài)，有無擴大、轉(zhuǎn)位。3正常測值左室橫徑舒張末期為3353CM，收縮末期為2442CM。,RELATIONSHIPBETWEENTHESHORTAXISPLANEWITHLEFTVENTRICULARWALLSEGMENTSINDICATED,ANDTHEAPICALFOURCHAMBER,TWOCHAMBER,ANDLONGAXISIMAGEPLANESPERPENDICULARTOTHESHORTAXISPLANE,６心尖四腔切面,１正常解剖結(jié)構(gòu)的超聲心動圖表現(xiàn)圖像右側(cè)自上向下依次為左心室、二尖瓣、左房，左側(cè)為右心室、三尖瓣、右房，中央為室間隔、房間隔。,２此切面選用范圍1觀察與測量心室及心房大小及形態(tài)；2觀察房、室間隔連續(xù)情況；3觀察室壁厚度及運動、有無局部運動異常（心肌缺血、梗死）或膨出（室壁瘤）；4觀察二尖瓣與三尖瓣數(shù)目、形態(tài)及開閉情況，測量兩隔葉根部附著位置間距離（EBSTEIN；5觀察心腔內(nèi)有無腫物（附壁血栓或心內(nèi)腫瘤）及其附著位置、大小、活動情況；6觀察三條（左上、左下、右上）肺靜脈是否均回入左房（肺靜脈異位引流）；7左心房內(nèi)有無隔膜（三房心）；8評價心功能。,心尖四腔切面,3正常測值①左室長徑舒張末期為70～84CM，收縮末期為50～64CM。②左房內(nèi)徑上下徑為31～53CM（收縮末期，二尖瓣環(huán)聯(lián)線中點至左房頂部），橫徑為30～53CM。（收縮末期，心房中部）。③右室內(nèi)徑橫徑為25～42CM（舒張末期徑），長徑為58～78CM（舒張末期徑）。④右房內(nèi)徑為34～4,9CM,橫徑為29～4,5CM（心尖四腔切面，收縮末期上下徑）。,心尖四腔切面SCHEMATICDIAGRAMOFTHEAPICALFOURCHAMBERVIEW,SHOWINGTHERELATIONSHIPSOFTHELEFTANDRIGHTVENTRICLESLVANDRVANDATRIALAANDRAINTHELEFTVENTRICLE,THEPAPILLARYMUSCLE,CHORDAE,ANDANTERIORANDPOSTERIORMITRALLEAFLETSAMVL,PMVLARESEENTHEDESCENDINGAORTADAISSEENINPARTIALCROSSSECTIONLATERALTOTHELEFTATRIUM,WHILETHERIGHTSUPERIORPULMONARYVEINRSPVDRAINSINTOTHELEFTATRIUMADJACENTTOTHEINTERATRIALSEPTUMINTHERIGHTVENTRICLE,THEMODERATORBANDMANDTHEANTERIORANDSEPTALTRICUSPIDVALVELEAFLETSATVLANDSTVLARESEENNOTETHEVENTRICULOATRIALSEPTUMVASSEPARATINGTHELEFTVENTRICLEFROMTHERIGHTATRIUMINASSOCIATIONWITHTHENORMAL,SLIGHTLYMOREAPICALPOSITIONOFTHETRICUSPIDCOMPAREDWITHTHEMITRALVALVEANNULUSTWODIMENSIONALECHOIMAGESINANAPICALFOURCHAMBERVIEWATENDDIASTOLEABOVEANDENDSYSTOLEBELOW,心尖四腔切面,心尖四腔切面SUBCOSTALVIEWSHOWINGALLFOURCARDIACCHAMBERS,,,7心尖兩腔切面,8主動脈弓長軸切面,SCHEMATICAND2DECHOIMAGESOFTHEAORTAINALONGAXISVIEWFROMTHESUPRASTERNALNOTCHWINDOWTHEASCENDINGAORTICAOARCHANDDESCENDINGTHORACICAORTAARESEENWITHTHEORIGINSOFTHELEFTCAROTIDANDSUBCLAVIANARTERIESTHERIGHTPULMONARYARTERYRPALIESIMMEDIATELYINFERIORTOTHEARCH,附心超常見縮寫表1,ABBREVIATIONDEFINITION2DTWODIMENSIONALIMAGING3DTHREEDIMENSIONALIMAGINGAMODEAMPLITUDEMODEAATRIALDIASTOLICVELOCITYPEAKAAREASEENINMATHEMATICALFORMULASAPEX2CAPICALTWOCHAMBERVIEWAPEX3CAPICALTHREECHAMBERVIEWALSOKNOWNASAPICALLONGAXISAPEX4CAPICALFOURCHAMBERVIEWAPEX5CAPICALFIVECHAMBERVIEWACTACCELERATIONTIMEAFATRIALFIBRILLATIONAMVLANTERIORMITRALVALVELEAFLETANTANTERIOR,AOAORTAAIAORTICINSUFFICIENCYASAORTICSTENOSISASCASCENDINGASDATRIALSEPTALDEFECTASHASYMMETRICALSEPTALHYPERTROPHYATVLANTERIORTRICUSPIDVALVELEAFLETAVAORTICVALVEAVAAORTICVALVEAREAAVRAORTICVALVEREPLACEMENTBAVBALLOONAORTICVALVULOPLASTYBPBLOODPRESSUREBSABODYSURFACEAREACPROPAGATIONSPEEDOFSOUNDINTISSUE,附心超常見縮寫表2,DBDECIBELDP/DTRATEOFCHANGEINPRESSUREOVERTIMEEENERGYECGELECTROCARDIOGRAMEDENDDIASTOLEEDDENDDIASTOLICDIMENSIONEDVENDDIASTOLICVOLUMEEFEJECTIONFRACTIONEPIEPICARDIUMEPSSEPOINTOFSEPTALSEPARATIONESENDSYSTOLEESDENDSYSTOLICDIMENSIONESPVRENDSYSTOLICPRESSUREVOLUMERELATIONSHIPESVENDSYSTOLICVOLUME,CADCORONARYARTERYDISEASECATHCARDIACCATHETERIZATIONCBVCATHETERBALLOONVALVULOPLASTYCHCHORDAECMCENTIMETERCM/SCENTIMETERPERSECONDCOCARDIACOUTPUTCONTEQCONTINUITYEQUATIONCOSCOSINECSCORONARYSINUSCSACROSSSECTIONALAREACXCIRCUMFLEXCORONARYARTERYDDIAMETERDADESCENDINGAORTA,附心超常見縮寫表3,ETTEXERCISETREADMILLTESTΔ?FREQUENCYSHIFT?FREQUENCYFLFALSELUMENFNNEARZONEFORESONANCEFREQUENCYOPERATINGFREQUENCYFSSCATTEREDFREQUENCYFSVFORWARDSTROKEVOLUMEFTTRANSMITTEDFREQUENCYFXFUNCTIONHCMHYPERTROPHICCARDIOMYOPATHYHPRFHIGHPULSEREPETITIONFREQUENCYHRHEARTRATEHVHEPATICVEINIINTENSITYIASINTERATRIALSEPTUM,INFINFERIORIVINTRAVENOUSIVCINFERIORVENACAVAIVCTISOVOLUMICCONTRACTIONTIMEIVRTISOVOLUMICRELAXATIONTIMEKHZKILOHERTZLLENGTHLALEFTATRIUMLAALEFTATRIALAPPENDAGELADLEFTANTERIORDESCENDINGCORONARYARTERYLAELEFTATRIALENLARGEMENTLAOLEFTANTERIOROBLIQUELATLATERALLAXXPARASTERNALLONGAXISLCCLEFTCORONARYCUSPLLDLEFTLATERALDECUBITUS,附心超常見縮寫表4,MSMITRALSTENOSISMVMITRALVALVEMVAMITRALVALVEAREAMVIMITRALVALVEINSUFFICIENCYMYXMYXOMANCCNONCORONARYCUSPΔPCHANGEINPRESSUREPPRESSUREPAPULMONARYARTERYPANPSEUDOANEURYSMPAPPULMONARYARTERYPRESSUREPDPULSEDDOPPLERPDAPATENTDUCTUSARTERIOSISPEPERICARDIALEFFUSIONPEPPREEJECTIONPERIODPISAPROXIMALISOVELOCITYSURFACEAREA,LMCALEFTMAINCORONARYARTERYLPALEFTPULMONARYARTERYLSPVLEFTSUPERIORPULMONARYVEINLVLEFTVENTRICLELVEDDLEFTVENTRICULARENDDIASTOLICDIMENSIONLVEDPLEFTVENTRICULARENDDIASTOLICPRESSURELVESDLEFTVENTRICULARENDSYSTOLICDIMENSIONLVHLEFTVENTRICULARHYPERTROPHYLVILEFTVENTRICULARINFLOWLVOLEFTVENTRICULAROUTFLOWLVOTLEFTVENTRICULAROUTFLOWTRACTMMODEMOTIONMODEMACMITRALANNULARCALCIFICATIONMBMODERATORBANDMIMYOCARDIALINFARCTION,附心超常見縮寫表5,PMPAPILLARYMUSCLEPMVLPOSTERIORMITRALVALVELEAFLETPOSTPOSTERIORPIPULMONARYINSUFFICIENCYPRFPULSEREPETITIONFREQUENCYPRFRPEAKRAPIDFILLINGTIMEPSPULMONARYSTENOSISPVPULMONICVALVEPTCAPERCUTANEOUSTRANSLUMINALCORONARYANGIOPLASTYPVPULMONARYVEINPVCPREMATUREVENTRICULARCONTRACTIONPWTPOSTERIORWALLTHICKNESSQVOLUMEFLOWRATEQPPULMONICVOLUMEFLOWRATEQSSYSTEMICVOLUMEFLOWRATERARIGHTATRIUM,RAERIGHTATRIALENLARGEMENTRAORIGHTANTERIOROBLIQUERAPRIGHTATRIALPRESSURERCARIGHTCORONARYARTERYRCCRIGHTCORONARYCUSPRFREGURGITANTFRACTIONRJREGURGITANTJETROAREGURGITANTORIFICEAREARPARIGHTPULMONARYARTERYRSPVRIGHTSUPERIORPULMONARYVEINRSVREGURGITANTSTROKEVOLUMERVRIGHTVENTRICLERVERIGHTVENTRICULARENLARGEMENTRVHRIGHTVENTRICULARHYPERTROPHYRVIRIGHTVENTRICULARINFLOWRVORIGHTVENTRICULAROUTFLOW,附心超常見縮寫表6,TGATRANSPOSITIONOFTHEGREATARTERIESTGCTIMEGAINCOMPENSATIONTITRICUSPIDVALVEINSUFFICIENCYTLTRUELUMENTOFTETRALOGYOFFALLOTTPVTIMETOPEAKVELOCITYTSTRICUSPIDSTENOSISTSVTOTALSTROKEVOLUMETTETRANSTHORACICECHOCARDIOGRAPHYTVTRICUSPIDVALVEVVELOCITYVVOLUMEVEGVEGETATION,RVOTRIGHTVENTRICULAROUTFLOWTRACTSAMSYSTOLICANTERIORMOTIONSAXXPARASTERNALSHORTAXISSCSUBCOSTALSSNSUPRASTERNALNOTCHSTSEPTALTHICKNESSSTJSINOTUBULARJUNCTIONSTVLSEPTALTRICUSPIDVALVELEAFLETSVSTROKEVOLUMESVCSUPERIORVENACAVASWMASEGMENTALWALLMOTIONABNORMALITYT1/2PRESSUREHALFTIMETTHROMBUSTEETRANSESOPHAGEALECHOCARDIOGRAPHY,
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