心血管造影在复杂和(或)复合先天性心脏病诊断中的应用  

Role of angiocardiography in the diagnosis and management of complex/complicated congenital heart disease

作　　者：凌坚[1] 刘玉清[1] 

机构地区：[1]中国医学科学院,中国协和医科大学心血管病研究所阜外心血管病医院放射科,北京100037

出　　处：《中华放射学杂志》2006年第12期1281-1285,共5页Chinese Journal of Radiology

基　　金：2002年度社会公益研究专项基金(2002DIB40092)

摘　　要：目的探讨心血管造影在先天性心脏病(简称先心病)复杂和(或)复合畸形中的应用价值。方法分析360例复杂和(或)复合畸形造影所见及其与超声心动图等临床检查的联系。结果本组360例(包括75例肺动脉闭锁合并室间隔缺损、62例右室双出口、60例法乐四联症、52例单心室、42例大动脉错位、15例三尖闭锁、6例冠状动脉异常、5例完整型肺静脉畸形连接、5例完全型心内膜垫缺损、4例共同动脉干、3例室间完整的肺动脉闭锁、7例其他病例和24例外科术后检查)心血管造影和超声对比,纠正后者误、漏诊分别为34、30例及对合并畸形误诊16例。对复杂和(或)复合畸形中体肺侧支血管、冠状动脉畸形和肺动脉段分支及其异常的检测和诊断优于超声心动图,并可测量肺动、静脉压力及体肺侧支血管压力而优于其他影像学检查方法。结论对于先心病复杂和(或)复合畸形的疑难病例诊断和鉴别诊断,尤其显示体、肺及冠状动脉分支的全貌及相关病变,以及测量肺动脉和心室压力等,心血管造影(含DSA)仍有重要或不可替代的作用。Objective To evaluate the role of angiocadiography （ACG） in the diagnosis and management of complex/complicated congenital heart disease （CHD）. Methods A retrospective study of ACG findings in 360 cases with complex/complicated CHD was performed with a comparision to that of echocardiography （Echo） and related clinical examination. Results The present series of CHD cases included pulmonary atresia with ventricular septal defect in 75 cases, double outlet of right ventricle in 62 cases, Fallot＇s tetralogy in 60 cases, single ventricle in 52 cases, transposition of the great arteries in 42 cases, tricuspid valve atresia in 15 cases, coronary abnormality in 6 cases, total abnormal pulmonary venous connection in 5 cases, total endocardial cushion defect in 5 cases, persistent truncus arteriosus in 4 cases, pulmonary atresia with normal ventricular septum in 3 cases, other disorders in 7 cases, and postsurgical operation in 24 cases. ACG was superior to that of Echo in demonstrating the abnormalities of systemic, pulmonary, and coronary arteries and their branches of complex/complicated CHD as well as measuring the pressure of pulmonary artery, vein, and systemic-pulmonary collateral vessels. Conclusion In the diagnosis and differential diagnosis of knotty cases with complex and complicated CHD, particularly in the demonstration of full view of systemic, pulmonary, and coronary arterial branches and accurate measurement of pulmonary arterial pressure/resistance, and atrial, ventricular, and systemic arterial pressure, ACG （including DSA） still plays an important and irreplaceable role.

关 键 词：心脏缺损 先天性 心血管畸形 心血管造影术 

分 类 号：R541.1[医药卫生—心血管疾病]