Download - 05. sieu am tim co ban
![Page 1: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/1.jpg)
SIÊU ÂM TIM CƠ BẢN
PGS. TS. Đỗ Doãn Lợi
TP Siêu âm Viện Tim mạch
P.Chủ tịch Phân Hội Siêu âm Tim Việt nam
![Page 2: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/2.jpg)
![Page 3: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/3.jpg)
![Page 4: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/4.jpg)
![Page 5: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/5.jpg)
Các vị trí đặt đầu dò siêu âm tim
![Page 6: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/6.jpg)
Sơ đồ siêu âm tim
![Page 7: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/7.jpg)
Sơ đồ
hệ thống
siêu âm tim
![Page 8: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/8.jpg)
Siêu âm 2 D và TM
![Page 9: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/9.jpg)
Các mặt cắt
siêu âm tim
![Page 10: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/10.jpg)
Các mặt cắt
siêu âm tim
![Page 11: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/11.jpg)
Các mặt cắt siêu âm tim
![Page 12: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/12.jpg)
TP
VLT
TT
ĐMC
LTVHL
LS VHL
NT
Mặt cắt cạnh ức trái trục dọc
![Page 13: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/13.jpg)
![Page 14: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/14.jpg)
![Page 15: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/15.jpg)
![Page 16: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/16.jpg)
![Page 17: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/17.jpg)
![Page 18: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/18.jpg)
VLTTP
LT VHL
LS VHL
Mặt cắt cạnh ức trái trục ngang
![Page 19: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/19.jpg)
TP
TT
CNCN
Mặt cắt cạnh ức trái trục ngang – thấp
![Page 20: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/20.jpg)
Mặt cắt cạnh ức trái trục ngang - cao
![Page 21: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/21.jpg)
Mặt cắt cạnh ức trái trục ngang - cao
![Page 22: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/22.jpg)
Mặt cắt cạnh ức trái - cao
![Page 23: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/23.jpg)
Mặt cắt từ mỏm tim – 3 buồng
![Page 24: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/24.jpg)
Mặt cắt từ mỏm tim – 4 buồng
![Page 25: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/25.jpg)
Mặt cắt từ mỏm tim – 5 buồng
![Page 26: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/26.jpg)
Mặt cắt từ mũi ức
![Page 27: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/27.jpg)
Dưới mũi ức trục ngang
![Page 28: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/28.jpg)
Mặt cắt từ mũi ức
![Page 29: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/29.jpg)
Mặt cắt từ mũi ức
![Page 30: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/30.jpg)
Dưới mũi ức
![Page 31: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/31.jpg)
Mặt cắt từ hõm trên ức
![Page 32: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/32.jpg)
Siêu âm 2 D và TM
![Page 33: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/33.jpg)
Siêu âm 2 D và TM
BÒ dµy c¸c thµnh TT:
. BÒ dµy cuèi t©m tr¬ng cña v¸ch liªn thÊt
(VLTd): 7,7 ± 1,3 mm
. BÒ dµy cuèi t©m thu cña v¸ch liªn thÊt
(VLTs): 10,4 ± 1,8 mm
. BÒ dµy cuèi t©m tr¬ng cña thµnh sau TT
(TSTTd): 7,1 ± 1,1 mm
. BÒ dµy cuèi t©m thu cña thµnh sau TT
(TSTTs): 11,7 ± 1,6 mm
§êng kÝnh buång TT:
. §êng kÝnh cuèi t©m tr¬ng cña TT (Dd):
46,5 ± 3,7 mm
. §êng kÝnh cuèi t©m thu cña TT (Ds):
30,3 ± 3,2 mm
![Page 34: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/34.jpg)
Siêu âm TM
Khèi lîng c¬ TT (KLCTT) - c«ng thøc Devereux:
KLCTT = 1,04 [(Dd + VLTd + TSTTd) 3 - Dd3] - 13,6
Bt: 139,64 ± 34,24 g cho c¶ hai giíi
ChØ sè khèi lîng c¬ TT (CSKLCTT): chÝnh x¸c h¬n, ®¸nh gi¸ tïy theo vãc d¸ng cña c¬ tõng ngêi (chiÒu cao, c©n nÆng, diÖn tÝch bÒ mÆt c¬ thÓ - Sda):
KLCTTCSKLCTT = ————————
Sda
Bt: nam 100,77 ± 19,96 g/m2n÷ 86,34 ± 16,87 g/m2
![Page 35: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/35.jpg)
Siêu âm TM
ThÓ tÝch thÊt tr¸i: c«ng thøc Teicholz
7 x d3V = ———————— d: ®k TT
2,4 + d
. ThÓ tÝch cuèi t©m tr¬ng TT (Vd): 101,1 ± 17,2 ml
. ThÓ tÝch cuèi t©m thu TT (Vs): 37,1 ± 8,8 ml
ChØ sè thÓ tÝch thÊt tr¸i (CSTTTT- VdI)
®¸nh gi¸ thÓ tÝch buång TT theo diÖn tÝch bÒ mÆt c¬ thÓ
Bt: 62,81 ± 10,54 ml/ m2
TT gi·n: VdI > 90 ml/ m2
![Page 36: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/36.jpg)
Thể tích thất trái Simpson
![Page 37: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/37.jpg)
Chức năng tâm thu thất trái
ChØ sè co ng¾n sîi c¬ (%D)
Dd - Ds
%D = ———————— x 100 (%)
Dd
Bt: 34,7 ± 6,3 %
Gi¶m: %D < 25 %
T¨ng (cêng ®éng): % D > 45
![Page 38: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/38.jpg)
Chức năng tâm thu thất trái
Ph©n suÊt tèng m¸u (EF - ejection fraction):
Vd - Vs
EF = ———————— x 100 (%)
Vd
Bt: 63,2 ± 7,3 %
![Page 39: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/39.jpg)
Chức năng tâm thu thất trái
Cung lîng tim (Q) vµ chØ sè tim (Qi):
Q = (Vd - Vs) x T.Sè tim
Qindex = Q/Sda
Bt: Q = 4 -5 l/ph
Qi = 3- 3,5 l/ph/m2
![Page 40: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/40.jpg)
S¬ ®å ph©n vïng tíi m¸u cña c¸c nh¸nh §MV chÝnh
Trôc dµi c¹nh øc Trôc ng¾n c¹nh øc
Bèn buång tim tõ mám Hai buång tim tõ mám
§M liªn thÊt tríc
§M mò
§M vµnh ph¶i
§M l.th.tríc + ph¶i
§M l.th.tríc + mò
Thµnh tríc
TT
NT
TTTP
NTNP
TTTT TP
TP
Thµnh sau
3
4
5 26
12
13 15
9
10
15
14
71 8
912
1110
8
1416
11
7
S¬ ®å ph©n vïng tíi m¸u cña c¸c nh¸nh §MV chÝnh
Trôc dµi c¹nh øc Trôc ng¾n c¹nh øc
Bèn buång tim tõ mám Hai buång tim tõ mám
§M liªn thÊt tríc
§M mò
§M vµnh ph¶i
§M l.th.tríc + ph¶i
§M l.th.tríc + mò
Thµnh tríc
TT
NT
TTTP
NTNP
TTTT TP
TP
Thµnh sau
33
44
55 2266
1212
1313 1515
99
1010
1515
1414
7711 88
991212
11111010
88
14141616
1111
77
![Page 41: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/41.jpg)
Van hai lá
![Page 42: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/42.jpg)
Van hai lá
![Page 43: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/43.jpg)
Mặt cắt cạnh ức trái trục ngang
![Page 44: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/44.jpg)
Van hai lá
![Page 45: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/45.jpg)
Siêu âm TM qua van hai lá
![Page 46: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/46.jpg)
Van động mạch chủ
![Page 47: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/47.jpg)
Van động mạch chủ
![Page 48: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/48.jpg)
Van động mạch chủ
![Page 49: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/49.jpg)
Van động mạch chủ
![Page 50: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/50.jpg)
Van động mạch phổi
![Page 51: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/51.jpg)
Van động mạch phổi
![Page 52: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/52.jpg)
Van động mạch phổi
![Page 53: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/53.jpg)
Van động mạch phổi
![Page 54: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/54.jpg)
Van động mạch phổi
![Page 55: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/55.jpg)
Van ba lá
![Page 56: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/56.jpg)
Van ba lá
![Page 57: 05. sieu am tim co ban](https://reader034.vdocuments.pub/reader034/viewer/2022052405/586fc9581a28aba24c8b65f7/html5/thumbnails/57.jpg)