先天性主动脉左室隧道的多普勒超声心动图诊断  

The diagnosis of aortic-left ventricular tunnel by Doppler Echocardiography

作　　者：吴力军[1] 张玉奇[2] 孙锟[1] 倪金洪[1] 高玲玲[1] 汪洁[1] 沈蓉[2] 

机构地区：[1]上海交通大学医学院附属新华医院超声中心,上海200092 [2]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：《医学影像学杂志》2010年第3期343-346,共4页Journal of Medical Imaging

摘　　要：目的:分析先天性主动脉左室隧道(ALVT)彩色多普勒超声心动图图像特征,评价多普勒超声心动图诊断ALVT的准确性。方法:回顾性总结了14例ALVT患者的超声检测结果,并与其外科手术结果相对照。结果:14例患者中超声心动图诊断正确11例(占78.6%),误诊2例(占14.3%),漏诊1例(占7.1%)。二维超声图像表现为主动脉前壁或后壁管状隧道结构与左心室流出道相通;彩色多普勒超声显像示收缩期血流信号从左心室流出道经隧道流向主动脉,舒张期血流信号从主动脉经隧道逆向进入左心室流出道。最常见的合并畸形为主动脉瓣返流。结论:多普勒超声心动图可以较准确地诊断ALVT,但需与主动脉瓣返流及主动脉窦瘤破裂相鉴别。Objective：To review the imaging characteristics of aortic-left ventricular tunnel（ALVT） and to evaluate the accuracy of the diagnosis by Doppler echocardiography.Methods：Doppler echocardiography was performed and these images were compared with operative findings in 14 patients.Results：11 of 14 of cases（78.6%） were diagnosed correctly,in the remaining 3 cases（21.4%）,2 cases（14.3%） were misdiagnosed,1 case（7.1%） were missed diagnosis.The features of echocardiographic images included： the parasternal long axis view of two-dimensional echocardiography image on the front or back wall of aortic valve showed tubal cavity was connected with left ventricular outflow-tract.Color Doppler showed that blood flow signals entered into the tunnel from left ventricular outlet during systolic time,and entered into the tunnel from aortic artery during diastolic time.Most patients were associated with aortic valve insufficiency.Conclusion：ALVT could be diagnosed accurately by Doppler echocardiography,but it should be differentiated from aortic valve insufficiency and the rapture of coronary aneurysm.

关 键 词：主动脉左室隧道 超声心动描记术 多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]