心下型完全性和部分性肺静脉异位引流的超声诊断经验  

Diagnostic Experience of Echocardiography in Patients With Infracardiac Total and Partial Anomalous Pulmonary Venous Connection

作　　者：王燕[1] 王浩[1] 段福建[1] 朱振辉[1] 逄坤静[1] 李永青[1] 孟红[1] 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院超声科,北京市100037

出　　处：《中国循环杂志》2014年第3期206-208,共3页Chinese Circulation Journal

摘　　要：目的:与外科手术结果对比分析,探讨超声心动图在心下型完全性和部分性肺静脉异位引流诊断中的应用。方法:2008-01至2012-12,经外科手术证实为心下型肺静脉异位引流的7例患者为研究对象,其中6例为完全性肺静脉异位引流,1例为部分性肺静脉异位引流,分析其超声心动图表现及诊断要点,与外科手术结果对比分析。结果:6例心下型完全性肺静脉异位引流患儿中,超声心动图均明确诊断,超声心动图诊断要点为共同肺静脉干走行向右下穿过膈肌,汇入门静脉或下腔静脉,但4例患儿合并动脉导管未闭,2例合并肺静脉狭窄,超声心动图仅提示1例肺静脉流速偏快。1例心下型部分性肺静脉异位引流患者,初次超声漏诊,术前复查时参考磁共振成像结果,发现异位引流的肺静脉走行途径。结论:超声心动图可以发现心下型完全性肺静脉异位引流的异常血流走行及汇入部位,可以准确诊断心下型完全性肺静脉异位引流,并具有无创、简便等优点,但应注意肺静脉狭窄等合并畸形的诊断。应加强对心下型部分性肺静脉异位引流的认识,有意识去剑突下切面探查以提高其诊断率。Objective： To explore the characteristics of echocardiography and the consistency with surgical findings in patients with infracardiac total and partial anomalous pulmonary venous connection. Methods： A total of 7 patients with surgical confirmed infracardiac anomalous pulmonary venous connection in our hospital from 2008-01 to 2012-12 were summarized. There were 6 patients with infracardiac total anomalous pulmonary venous connection （TAPVC）, 1 with infracardiae partial anomalous pulmonary venous connection （PAPVC）, the characteristics of echocardiography were analyzed and compared with the surgical findings. Results： All 6 infracardiac TAPVC patients were correctly diagnosed by echocardiography with the characteristics of common pulmonary vein inferiorly drained to portal vein or inferior vena cava; while for 4 cases combining patent ductus arteriosus and 2 cases combining pulmonary venous stenosis, the echocardiography only indicated for faster flow of pulmonary vein in 1 case. 1 infracardiac PAPVC patient was misdiagnosed at the first time, the pre-operative MRI examination found the abnormally drained pulmonary vein pathway. Conclusion： The echocardiography may correctly diagnose the infracardiac TAPVC with the advantage of non- invasive and easy performance, special attention should be concentrated to the patients combining pulmonary venous stenosis. The echocardiographic diagnosis for PAPVC should be improved.

关 键 词：心下型肺静脉异位引流 超声心动图 诊断 

分 类 号：R541[医药卫生—心血管疾病]