室间隔完整的肺动脉闭锁彩色多普勒超声心动图特征及规律性研究  

Characteristics and Regularity of Color Doppler Echocardiography of Pulmonary Atresia with Intact Ventricular Septum

作　　者：侯传举[1] 李波[2] 许兆柱[1] 邓东安[1] 朱鲜阳[1] 

机构地区：[1]沈阳军区总医院,沈阳市110840 [2]沈阳医学院沈洲医院

出　　处：《中国超声医学杂志》2010年第12期1088-1091,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探寻室间隔完整的肺动脉闭锁(PAIVS)彩色多普勒超声心动图(CDE)特征及规律性。方法应用CDE检查35例PAIVS,寻找CDE特征和规律性,28例心血管造影对照,4例经手术证实,9例行介入治疗。结果根据CDE特征对33例做出正确诊断,诊断准确率94.3%,1例误诊重症法洛三联症,另1例误诊为孤立性右心室发育不全。PAIVS的CDE特征及规律性明显:(1)二维超声心动图(2DE)胸骨旁左室长轴切面显示室间隔回声完整,室间隔和右心前室壁增厚。(2)2DE心尖四腔心切面显示2个心房正位,2组房室瓣开向2个心室腔,室间隔回声完整,室间隔和右心室壁增厚,房间隔不同大小回声中断,右心房内径增大。彩色多普勒血流显像(CDFI)显示过三尖瓣五彩镶嵌反流束血流信号,过房间隔右向左五彩镶嵌分流束血流信号,合并三尖瓣狭窄显示过三尖瓣五彩镶嵌射流束血流信号。(3)2DE胸骨旁大动脉短轴切面显示2条大动脉位置关系正常,肺动脉瓣无开放运动,CDFI均显示过三尖瓣五彩镶嵌反流束血流信号和过动脉导管左向右五彩镶嵌分流束血流信号,肺动脉瓣无血流信号通过。(4)房间交通和动脉导管未闭直径大的患者存活时间相对较长。结论 PAIVS的CDE特征及规律性明显,CDE对PAIVS有特异性诊断价值,但需与重症法洛三联症和孤立性右心室发育不全鉴别诊断。一旦确诊PAIVS,应尽早采取治疗措施。Objective To observe the characteristics and regularity of the images of pulmonary atresia with intact ventricular septum（PAIVS） by color Doppler echocardiography（CDE）. Methods Thirty-five patients of PAIVS were examined by CDE,28 cases of which were compared with angiocardiography. 4 cases were verified by operation. 9 cases underwent interventional therapy. Results Thirty-three patients were properly diagnosed based on CDE characteristics with diagnostic accuracy 94.3 %. 1 case was misdiagnosed as severe trilogy of Fallot. Another case was misdiagnosed as isolated right ventricular hypoplasia. CDE characteristics and regularity of PAIVS were obvious： （1） Two-dimensional echocardiography（2DE）parastermal left v^ntricle long axis view showed intact and thickening echo of interventricular septum and a thickened anterior wall of right ventricle. （2） Apical four chamber view of 2DE showed atrial situs solitus with atrioventricular valves opening to the 2 ventricles separately, intact and thickened interventricular septum, thickened right ventricular wall, various size of echo interruption of interatrial septum and enlarged right atrium. Color Doppler flow imaging（CDFI） showed colorful reflux signals through tricuspid valve and colorful shunt flow signals through interatrial septum. Jet flow signals could also be seen when associated with tricuspid stenosis. （3） In parasternal short axis view of 2DE, the two great arteries showed normal relationship with no opening on pulmonary artery valve. CDFI showed colorful reflux signals through tricuspid valve and left to-right shunt flow through ductus arteriosus but no flow through pulmonary valve. （4） The bigger the diameters of interatrial transport and patent ductus arteri- osus were the longer the survival time would be. Conclusions CDE imaging characteristics and regularity of PAIVS are obvious. CDE is valuable in diagnosing PAIVS,but it should be differentiated from severe trilogy of Fallot and isolated right ventricular bypopiasia. Onc

关 键 词：先天性心脏病 室间隔完整的肺动脉瓣闭锁 彩色多普勒超声心动图 

分 类 号：R540.45[医药卫生—心血管疾病] R541.1[医药卫生—内科学]