練合 泰明, 吉田 茂夫, 伊東 佳澄, 福田 守道

Yasuaki NERIAI, Shigeo YOSHIDA, Kasumi ITO, Morimichi FUKUDA

札幌医科大学機器診断部

Department of Ultrasound and Electronics, Sapporo Medical College

キーワード : Mitral valve aneurysm, TTE, TEE

Mitral valve aneurysm is a rare disease. In Japan only 26 cases have been reported so far, and its diagnosis has been difficult even by angiography and transthoracic echocardiography (TTE). The recent introduction of transesophageal echocardiography (TEE) has provided more precise information because of its high resolution. To clarify echocardiographic findings on mitral valve aneurysms, we critically examined four cases of mitral valve aneurysm by TTE and TEE. Five echocardiographic images were evaluated as being useful for diagnosing mitral valve aneurysm. These echo patterns were 1) Abnormal multilayered echo image between the anterior and posterior mitral valve leaflets during diastole (by M mode of TTE); 2) Dome formation of the mitral valve during systole; 3) Doming formation maintained throughout diastole; 4) Turbulent flow within the dome formation during systole; 5) Mitral regurgitation from the perforation of the dome when the mitral valve aneurysm is perforated (by TEE). Four (1∼4) images were detected in all four cases of mitral valve aneurysm. The abnormal multilayered echo image by TTE, the diastolic doming formation, and systolic turbulent flow within the dome formation by TEE were the most useful means to diagnose mitral valve aneurysm.