为进一步提高心脏超声在冠心病中的诊断应用价值，本文就不同类型冠心病的超

为进一步提高心脏超声在冠心病中的诊断应用价值，本文就不同类型冠心病的超声图像特征进行总结如下[6]：①心绞痛与无症状性心肌缺血：主要症状为心肌缺血，通常表现为缺血节段室壁运动减弱，严重者也可表现为运动消失；而室壁运动异常，当心肌缺血时，局部室壁运动减弱，同时受邻近正常室壁运动牵扯而使整个室壁运动出现不协调，在左室短轴切面上可出现顺时针或逆时针扭动。②心肌梗死：在急性心肌梗死后，超声心动图几乎立即可检出室壁运动异常，典型表现为室壁收缩期变薄及矛盾运动，若患者存在较大范围的心肌梗死，还会在正常区室壁运动的同时出现运动增强。此外，急性心肌梗死早期表现为心肌回声减弱，以后逐渐增强，陈旧性心肌梗死，局部室壁内可出现点状、条带状高回声。部分急性心肌梗死患者可出现少量心包积液。③心肌梗死并发症：较为常见的有室壁瘤，图像特征为局部室壁向外膨出，膨出部分室壁变薄，呈矛盾运动，即收缩期向外、舒张期向内运动，其中收缩期更加显著；瘤壁存在交界区，系正常心肌组织向坏死心肌逐渐转化而形成；室壁瘤与心腔的交通口较宽，其长径大于或等于瘤腔的最大径。室间隔穿孔：超声特点为肌部室间隔回声连续性中断或呈隧道样缺损，缺损口边缘不整齐，大小随心动周期变化；穿孔附近周围室壁运动异常；CDFI可见穿孔处左向右异常分流。

In order to further improve the diagnostic value of cardiac ultrasound in coronary heart disease, this paper summarizes the ultrasonic image characteristics of different types of coronary heart disease as follows [6]: ① angina pectoris and asymptomatic myocardial ischemia: the main symptom is myocardial ischemia, which usually shows the weakening of ventricular wall motion in ischemic segments, and in severe cases, it can also show the disappearance of motion; The ventricular wall motion is abnormal. When myocardial ischemia, the local ventricular wall motion is weakened. At the same time, the whole ventricular wall motion is uncoordinated due to the adjacent normal ventricular wall motion. Clockwise or counterclockwise torsion can occur on the short axis section of the left ventricle. ② Myocardial infarction: after acute myocardial infarction, abnormal ventricular wall motion can be detected almost immediately by echocardiography, which is typically characterized by ventricular wall thinning and contradictory motion in systole. If the patient has a large-scale myocardial infarction, there will be enhanced motion while ventricular wall motion in normal area. In addition, in the early stage of acute myocardial infarction, the myocardial echo is weakened, and then gradually enhanced. In the old myocardial infarction, there can be punctate and banded hyperecho in the local ventricular wall. Some patients with acute myocardial infarction may have a small amount of pericardial effusion. ③ Complications of myocardial infarction: ventricular aneurysm is more common. The image feature is that the local ventricular wall bulges outward, and the bulged part of the ventricular wall becomes thinner, showing contradictory movement, that is, outward movement in systole and inward movement in diastole, especially in systole; There is a junction area in the tumor wall, which is formed by the gradual transformation of normal myocardial tissue to necrotic myocardium; The communicating port between ventricular aneurysm and cardiac cavity is wide, and its length diameter is greater than or equal to the maximum diameter of tumor cavity. Ventricular septal perforation: the ultrasonic characteristics are continuous interruption or tunnel like defect of muscular ventricular septal echo, irregular edge of defect mouth, and the size changes with cardiac cycle; Abnormal wall motion near perforation; CDFI showed abnormal left to right shunt at the perforation.<br>

In order to further improve the diagnostic application value of cardiac ultrasound in coronary heart disease, this paper summarizes the ultrasonic image features of different types of coronary heart disease as follows [6]: ① Angina pectoris and asymptomatic myocardial ischemia: the main symptom is myocardial ischemia, which is usually manifested as decreased wall motion in ischemic segment, and in severe cases, it can also be manifested as motion disappearance; However, the wall motion is abnormal. When the myocardium is ischemic, the local wall motion is weakened, and the whole wall motion appears uncoordinated due to the motion of the adjacent normal wall. Clockwise or counterclockwise twisting may appear on the short axis section of the left ventricle. ② Myocardial infarction: After acute myocardial infarction, abnormal wall motion can be detected almost immediately by echocardiography, which is characterized by wall thinning during systole and contradictory motion. If the patient has a large range of myocardial infarction, there will be motion enhancement at the same time as normal wall motion. In addition, the early manifestation of acute myocardial infarction is decreased myocardial echo, and then gradually increased. In the case of old myocardial infarction, dot-like and strip-like hyperecho may appear in the local ventricular wall. Some patients with acute myocardial infarction may have a small amount of pericardial effusion. ③ Complications of myocardial infarction: Ventricular aneurysm is more common, and its image features are that the local wall bulges outwards, and some of the bulged wall thins, showing contradictory movement, namely, systolic outward movement and diastolic inward movement, among which systolic movement is more significant; There is a junction area in the tumor wall, which is formed by the gradual transformation of normal myocardial tissue into necrotic myocardium. The communication port between ventricular aneurysm and heart cavity is wide, and its long diameter is greater than or equal to the maximum diameter of the tumor cavity. Ventricular septal perforation: the ultrasonic characteristics are that the echo continuity of muscular ventricular septum is interrupted or it is a tunnel-like defect, the edge of the defect is irregular, and the size changes with the cardiac cycle; Abnormal wall movement around perforation; CDFI showed abnormal shunt from left to right at perforation.