超声心动图对儿童左冠状动脉起源异常的诊断分析  

Echocardiographic Diagnosis of Anomalous Origin of Left Coronary Artery in Children

作　　者：王芳韵[1] 金兰中[1] 刘辉[2] 马桂琴[1] 卫海燕[1] 郑淋[1] 张鑫[1] 

机构地区：[1]首都医科大学附属北京儿童医院心脏中心心脏超声室,北京市100045 [2]首都医科大学附属北京儿童医院心脏中心心脏监护室,北京市100045

出　　处：《中国超声医学杂志》2008年第7期651-653,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声心动图对儿童左冠状动脉起源异常如何早期正确诊断及其临床价值。方法以经冠状动脉造影、CT重建或手术证实的7例左冠状动脉起源异常患儿为研究对象,回顾分析其超声心动图特点、鉴别诊断要点及误诊原因。结果7例左冠状动脉起源异常患儿,超声心动图确诊4例,2例误诊为心内膜弹力纤维增生症,1例漏诊,超声表现为各切面均未见左冠状动脉开口于主动脉左冠窦,右冠状动脉开口于主动脉右冠窦,肺动脉根部后壁、左前壁或右冠状动脉主干发出左冠状动脉,部分病例肺动脉内见异常血流信号。结论超声心动图能够早期准确诊断儿童左冠状动脉起源异常,关键是对本病有充分的认识,其方法既无创又有较强的重复性,对尽早手术治疗提高患儿的生存率具有重要的临床意义。Objective To explore the clinical value of echocardiography in diagnosing anomalous origin of left coronary artery correctly and early in children in Beijing Children＇s Hospital. Methods The characteristics of echocardiography, correct diagnosis and missed diagnosis reasons were analysed. Results Seven patients with the anomalous origin of left coronary artery in our study. Four patients were diagnosed on echocardiography; two patients were missed diagnosed as endocardial fibroelastosis; the other one was missed diagnosis. The characteristics of the echocardiography were .. the opening orifice of left coronary artery was absent in right place in every echo sections ; the opening orifice of right coronary artery was in right place; left coronary artery origined from pulmonary artery or right coronary artery ; in some cases, abnormal blood signal was present in pulmonary artery. Conclusions We can make early and correct diagnosis of anomalous origin of left coronary artery, but the key point is to have enough recognition knowledge of the malformation. This method is noninvasive, safe and reproducible. Anomalous correction surgery should be performed as early as possible to improve patient＇s survival rate which is significant.

关 键 词：左冠状动脉起源异常 超声心动图 诊断分 儿童 心内膜弹力纤维增生症 经冠状动脉造影 左冠状动脉开口 冠状动脉主干 

分 类 号：R725.4[医药卫生—儿科]