超声结合CTA诊断心下型完全性肺静脉异位引流畸形  

Echocardiography Diagnosis of Infracardiac Total Anomalous Pulmonary Venous Drainage Combined with CTA

作　　者：刘咏芳[1] 姜淑英[1] 吴道珠[1] 黄福光[1] 孙海燕[1] 程建敏[2] 胡型锑[3] 

机构地区：[1]温州医学院附属第二医院超声科,浙江省温州市325027 [2]温州医学院附属第二医院放射科,浙江省温州市325027 [3]温州医学院附属第二医院胸外科,浙江省温州市325027

出　　处：《中国超声医学杂志》2013年第3期218-221,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨心下型完全性肺静脉异位引流(ITAPVD)的超声和CTA的特征性表现。方法 10例心下型TAPVD患者首诊均行经胸超声心动图检查,其中7例又行CT血管造影检查(CTA),并与手术结果进行对照分析。结果 10例心下型TAPVD均经手术证实。超声心动图首诊准确率为70%(7/10),误漏诊率为30%(3/10),7例CTA诊断准确率为100%。心下型TAPVD的超声和CTA的特征性表现是:共同肺静脉内径较其他类型TAPVD的细小;剑下主动脉横断面可见三条血管的横断面,即连接共同肺静脉的垂直静脉位于主动脉前方、下腔静脉左后方;肝内门静脉扩张迂曲;CDFI显示垂直静脉与下腔静脉血流方向相反,5例垂直静脉与之连接的部位狭窄,出现流速增快成湍流。结论掌握心下型TAPVD的特征性超声表现,经胸超声心动图仍是诊断ITAPVD的首选方法 ,结合CTA检查可提高诊断准确率,避免误漏诊。Objective Explore the ultrasound and CTA characteristic of performance infracardiac total anomalous pulmonary venous drainage （TAPVD）. Methods Ten infracardiac TAPVD patients were diagnosed first by transtho- racic echocardiography, Of which seven cases were performed CT angiography （CTA）. All cases were compared with surgical findings. Results Ten cases of Infracardiac TAPVD were confirmed by surgery. Echocardiography diagram first diagnosis accuracy rate was 70%, Misdiagnosis rate was 30%. CTA diagnostic accuracy was 100% in seven ca- ses. The characteristic performances of Infracardiac TAPVD in ultrasound and CTA are ： the diameter of common pul- monary vein is smaller when compare to other types of TAPVD; Cross-section of three vessels can be seen in the sub- xyphoid view of aortic cross-section ; Intrahepatic portal veins dilate tortuously; CDFI showed the blood flow of verti- cal vein and inferior vena cava are in the opposite direction, stenosis of vertical vein connecting parts occur in 5 cases, with increaed velocity of the flow and turbulence. Conclusions Transthoracic ultrasonogrphy is the first choice of method to diagnose Infracardiac TAPVD when we are familiar with the characteristic ultrasonogrphic performance of this disease. Combined with CTA, it can improve the diagnostic accuracy and avoid misdiagnosis.

关 键 词：心下型完全性肺静脉异位引流 超声检查 CTA 

分 类 号：R725.4[医药卫生—儿科] R540.45[医药卫生—临床医学]