经胸超声心动图诊断小儿双动脉干下型与肌部流出道型室间隔缺损  

Transthoracic Echocardiographic Diagnosis of Doubly Committed Subarterial Ventricular Septal Defect and Muscular Outlet Ventricular Septal Defect

作　　者：王树水[1,2] 曾国洪[1,2] 张智伟[1,2] 岑坚正[1,3] 李虹[1,2] 潘微[1,2] 李江林[1,2] 

机构地区：[1]广东省心血管病研究所 [2]广东省人民医院 广东省医学科学院心儿科,广州市510100 [3]广东省人民医院 广东省医学科学院 心外科,广州市510100

出　　处：《中国超声医学杂志》2012年第8期730-733,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家十一五科技支撑计划项目(No.2007BAI05B03)

摘　　要：目的总结双动脉干下型室间隔缺损(ventricular septal defect,VSD)与肌部流出道型VSD的经胸超声心动图特点,探讨二者的经胸超声鉴别方法。方法对372例小儿双动脉干下型VSD及61例小儿肌部流出道型VSD进行经胸超声心动图检查,将超声检查结果与外科手术所见进行对照。结果双动脉干下型VSD中,超声诊断正确353例,误诊为肌部流出道型18例,误诊为多发VSD1例。肌部流出道型VSD中,超声诊断正确51例,误诊为双动脉干下型9例,误诊为膜周流出道型VSD1例。结论双动脉干下型VSD与肌部流出道型VSD容易混淆,但二者具有不同的超声心动图特点。多切面仔细扫查,有利于二者的鉴别。Objective To summarize ultrasonographic features of doubly committed subarterial and muscular outlet ventricular septal defect （VSD） and to explore their differential diagnosis. Methods 372 children with doubly corn mitted subarterial VSD and 61 children with muscular outlet VSD were carefully examined on transthoracic ultrasonography. The results of transthoracic ultrasonography were compared with intro-operative findings. Results In doubly committed subarterial VSD group, 18 patients were misdiagnosed as muscular outlet VSD and 1 child was misdiagnosed as multiple defects. In muscular outlet VSD group, 9 patients were misdiagnosed as doubly committed subarterial VSD and one misdiagnosed as perimembranous outlet VSD. Conclusions Ultrasonographic features of doubly com mitted subarterial VSD and muscular outlet VSD are different. Careful scanning on different sections can improve the diagnostic accuracy of the two types of VSD.

关 键 词：室间隔缺损 超声心动描记术 鉴别诊断 小儿 

分 类 号：R540.45[医药卫生—心血管疾病] R725.4[医药卫生—内科学]