Abstract：Objective: To improve the contrast of myocardium and cardiac cavity by left ventricular opacification, and to diagnose and evaluate apical hypertrophic cardiomyopathy. Methods: We selected 21 patients clinically suspected of apical hypertrophic cardiomyopathy with abnormal change of electrocardiogram, excluded diseases such as high blood pressure, aortic valve disease and so on which may cause secondary myocardial hypertrophy. There was no other segmental myocardial abnormal thickening of the change in the two-dimensional echocardiography imaging, only the apex of heart was not clear by image display forthe near field artifacts and acoustic window limit, gas interference or by reason of patients with obesity caused. Twenty-one cases of patients undergoed left ventricular opacification, organized and analysis the images. Twenty patients without heart disease as a normal control group. Results: Twenty-one cases of patients with imaging process did not feel any discomfort. The ultrasound imaging of left ventricular opacification success showed apex of 20 cases(95.2%). Including 2 cases of apex of myocardial no obvious thickening, 18 patients with apical myocardial thickening, thickness of about 14~17 mm. The apical apical segment of the myocardium with a radial distribution of a large number of trabeculae and deep recess filled with contrast media. After left ventricular opacification, we can clearly observe that the left ventricular apex of the left ventricle is obviously narrowed or even completely occluded. One case(4.8%) patients with left ventricular ejection fraction, contrast agent fails to reach the apex, failed to development. There was no significant difference between EF and control group in apical hypertrophic cardiomyopathy, but EDV and ESV were significantly lower than those in control group. Conclusion: Left ventricular opacification can increase the diagnostic accuracy of apical hypertrophic cardiomyopathy by improving the clarity of the cardiac ultrasound image, measuring the thickness of the apical myocardium accurately, and judging the change of the cardiac cavity size.
李 颖. 左室心腔造影对心尖部肥厚型心肌病的诊断分析[J]. 中国临床医学影像杂志, 2017, 28(12): 841-843.
LI Ying. The diagnostic analysis of apical hypertrophic cardiomyopathy with left ventricular opacification. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(12): 841-843.
[1]Kutty S, Xiao Y, Olson J, et al. Safety and Efficacy of Cardiac Ultrasound Contrast in Children and Adolescents for Resting and Stress Echocardiography[J]. J Am Soc Echocardiogr, 2016, 29(7): 655-662.
[2]杨道玲，陆永萍，孙月，等. 兔急性心肌梗死模型制备的超声造影研究[J]. 中国超声医学杂志，2015，31（9）：830-833.
[3]Cavalcante JL, Collier P, Plana JC, et al. Two-dimensional longitudinal strain assessment in the presence of myocardial contrast agents is only feasible with speckle-tracking after microbubble destruction[J]. J Am Soc Echocardiogr, 2012, 25(12): 1309-1318.
[4]Platts DG, Luis SA, Roper D, et al. The safety profile of perflutren microsphere contrast echocardiography during rest and stress imaging: results from an Australian multicentre cohort[J]. Heart Lung Circ, 2013, 22(12): 996-1002.
[5]李波，詹树生，詹晓英，等. 经胸超声心动图声学造影联合经颅多普勒声学造影在脑血管疾病人群中筛查卵圆孔未闭的应用价值[J]. 中华医学超声杂志：电子版，2016，13（9）：667-669.
[6]孙月，杨道玲，王禹雪，等. 超声心动图常规及新技术评价兔心肌梗死模型[J]. 中国超声医学杂志，2016，32（7）：648-651.
[7]Aintablian HK, Narayanan V, Belnap N, et al. An atypical presentation of ACAD9 deficiency: Diagnosis by whole exome sequencing broadens the phenotypic spectrum and alters treatment approach[J]. Mol Genet Metab Rep, 2016, 29(10): 38-44.
[8]邢晓博，刘福颂，王芳，等. 肥厚型心肌病心肌肌钙蛋白C基因TNNC1c.G175C突变一家系[J]. 中华心血管病杂志，2016，44（12）：1020-1023.
[9]Muthukumar L, Jan MF, Whitnah J, et al. Coexistence of apical hypertrophic cardiomyopathy and endomyocardial fibrosis with calcification: diagnosis using multimodality imaging[J]. ESC Heart Fail, 2016, 3(4): 278-281.
[10]Maron BJ, Maron MS. A Discussion of Contemporary Nomenclature, Diagnosis, Imaging, and Management of Patients With Hypertrophic Cardiomyopathy[J]. Am J Cardiol, 2016, 118(12): 1897-1907.
