房室间隔缺损的无创伤诊断  

Noninvasive preoperative diagnosis in children with atrioventricular septal defects

作　　者：张晓洁[1] 张玉奇[1] 陈笋[1] 张志芳[1] 沈蓉[1] 黄美蓉[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心内科,上海200127

出　　处：《临床儿科杂志》2009年第5期417-419,共3页Journal of Clinical Pediatrics

摘　　要：目的评价二维多普勒超声心动图(2-DE)诊断房室间隔缺损(AVSD)的准确性。方法选择122例经手术明确诊断为AVSD的患儿,以手术后诊断为金标准,分析术前2-DE和心导管及心血管造影(CATH)诊断的灵敏度、特异度。结果2-DE对部分性房室间隔缺损(PAVC)的诊断灵敏度和特异度为97.5%和99.9%,对完全性房室间隔缺损(CAVC)和过渡性房室间隔缺损(TAVC)的诊断灵敏度和特异度为93.9%和99.9%;CATH对PAVC的诊断灵敏度和特异度为87.5%和99.9%,对CAVC和TAVC的诊断灵敏度和特异度为97.8%和99.8%。2-DE与CATH诊断比较差异均无统计学意义。结论2-DE可对AVSD作出较为准确的诊断,但在2-DE提示存在明显肺动脉高压或合并其他心内畸形时,需进一步行心导管和心血管造影检查。Objective To evaluate the value of echocardiography in diagnosis of atrioventricular septal defects （AVSD）. Methods Records of two dimensional color Doppler （2-DE） , catheterization （CATH） and post-operative diagnosis of 122 children with AVSD were reviewed. The sensitivity and specificity of the preoperative diagnosis of 2-DE and CATH were evaluated and the intraoperative diagnosis made by surgical inspection served as the golden standard. Results The diagnostic sensitivity and specificity of 2-DE in detecting partial atrioventricular canal was 97.5% and 99.9% compared with 87.5% and 99.7% by CATH. The diagnostic sensitivity and specificity of 2-DE in detecting complete atrioventricular canal and transitional atrioventricular canal was 93.9% and 99.9% compared with 97.8% and 99.8% by CATH. The differences between 2-DE and CATH were not statistically significant in detection of AVSD. Conclusions This study suggests that echocardiography alone is a reliable tool for the preoperative diagnosis of AVSD. Cardiac catheterization is required to be performed if echocardiographic suggested the presence of pulmonary hypertension or of uneasily defined cardiac anomalies.

关 键 词：二维多普勒超声心动图 房室间隔缺损 儿童 

分 类 号：R726.5[医药卫生—儿科]