超声心动图与心导管造影检查在小儿复合型先天性心脏病诊断中的比较  

Comparison between Color Doppler Echocardiography and Angiocardiography in Diagnosis of Children's Combined with Congenital Heart Diseases

作　　者：赵胜[1] 江荣[1] 吴梦琦[2] 李庚武[3] 余东[1] 

机构地区：[1]安徽省立儿童医院心内科,合肥230051 [2]安徽省立儿童医院超声室,合肥230051 [3]安徽省立儿童医院放射科,合肥230051

出　　处：《实用儿科临床杂志》2009年第1期44-45,55,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的评价彩色多普勒超声心动图(CDE)和心导管造影(ANGI)检查在小儿复合型先天性心脏病诊断中的作用。方法选择2006年1月-2008年6月同时进行CDE和ANGI检查的复合型先天性心脏病患儿31例,其中18例行外科手术治疗,对2种检查方法所做主要诊断及伴发畸形进行比较,行外科手术者亦与手术所见心血管畸形进行比较。结果18例手术患儿中,CDE检查15例(83.33%)、ANGI检查17例(94.44%)与手术结果相一致。心内结构中CDE和ANGI检查结果不同处在于:CDE将1例肺动脉闭锁/室间隔缺损(PA/VSD)误诊为永存动脉干(PTA),2例法洛四联症(TOF)误诊为PA/VSD,CDE疑诊而ANGI漏诊部分肺静脉异位引流(PAPVC)1例,以上结果均被手术证实;除主要诊断外,CDE漏诊房间隔缺损(ASD)、右冠状动脉起源异常、单支左冠状动脉各1例。心外大血管畸形中CDE和ANGI检查结果不同在于:对1例主动脉弓离断(IAA),CDE疑诊而ANGI确诊并分型,CDE漏诊双主动脉弓(DAA)、肺动静脉漏(PAVF)、动脉导管未闭(PDA)和右肺动脉缺如各1例,CDE还报告4例PA/VSD患儿并PDA,但ANGI检查并未发现。结论CDE和ANGI检查结果不同之处主要在于包括冠状动脉在内的心脏外血管畸形,2种检查相结合可提高复合型先天性心脏病诊断的准确率。Objective To evaluate roles of color doppler echocardiography（CDE） and angiocardiography（ANGI） in diagnosis of children＇s combined with congenital heart disease.s（CHD）. Methods From Jan. 2006 to Jun. ：2008,31 children with combined with CHD under- went not only CDE but also ANGI. Of thnse, 18 cases were subjected to surgical operation. Main diagnosis and concomitant cardiovascular malformations derived from CDE and ANGl,operative findings as well, were compared. Results In 18 cases undergoing surgery, diagnosis of 15 （83.33%） cases from CDE and 17 （94.44%） cases from ANGI were in line with the operative findings. Of intracardiac malformations, diffe- rences between CDE and ANGI were：CDE diagnosed 1 case with pulmonary atresia / ventricular septal defect （PA/VSD） as persistent trun- cus arteriosus （PTA） ,2 cases with tetralogy of Fallot （TOF） as PA/VSD by mistake,and 1 case with partial anomalous pulmonary venous connection （PAPVC） was suspected by CDE but missed by ANGI,all above mentioned confirmed by sugery;except main diagnosis,CDE missed atrial septal defect （ASD） ,anomalous origin of right coronary artery and single left coronary for 1 case ,respectively. In diagnosing ext- racardiac abnormal structures： 1 case of interrupted aortic arch （IAA） was suspected by CDE but diagnosed and classified by ANGl;for doub- le aortic arch （ DAA）, pulmonary arteriovenous fistula （PAVF）, patent ductus arteriosus （PDA） and absence of right pulmonary artery, 1 case of each was missed by CDE;furthermore PDA reported by CDE but not found by ANGI in 4 cases with PA/VSD. Conclusions The diagnostic difference between CDE and ANGI mainly lies in extracardiac malformations including coronary arteries. In diagnosing conhined CHD,combination of CDE and ANGI can improve accurate rate.

关 键 词：心脏病 先天性 超声心动描记术 心血管造影术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.4[医药卫生—诊断学]