超声心动图诊断小儿左冠状动脉起源于肺动脉的应用价值  

Value of echocardiography in the diagnosis of anomalous origin of left coronary artery from the pulmonary artery

作　　者：俞劲[1] 彭学慧[1] 叶菁菁[1] 何瑾[1] 蒋国平[1] 

机构地区：[1]浙江大学医学院附属儿童医院超声科,杭州310003

出　　处：《中华超声影像学杂志》2014年第5期383-386,共4页Chinese Journal of Ultrasonography

摘　　要：目的 探讨超声心动图对小儿左冠状动脉起源于肺动脉（ALCAPA）的诊断价值.方法 总结、分析14例经手术证实的ALCAPA的超声心动图表现,并与心内膜弹力纤维增生症（EFE）的超声心动图表现进行比较.结果 ALCAPA可有EFE的超声表现：左室增大,左室收缩功能减低,心内膜增厚,二尖瓣反流.ALCAPA主要表现为右冠状动脉起源正常,内径增宽;左冠状动脉开口于肺动脉根部或主干,红色血流逆流入肺动脉;心肌侧支血流丰富.结论 彩色多普勒超声心动图能清楚显示冠状动脉起源及走行、血流情况,有助于ALCAPA的早期确诊.Objective To explore the value of echocardiography in the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery （ALCAPA） in children.Methods The echocardiographic images of 14 patients with ALCAPA confirmed by operation and 18 patients with endocardial fibroelastosis （EFE） diagnosed by clinical were compared and analyzed.Results Both ALCAPA and EFE exhibited obvious dilated left ventricle,decreased left ventricular systolic function,thick endocardium and mitral regurgitation of different degree.The former additionally showed dilated right coronary artery（RCA） with normal origin,left coronary artery（LCA） emerging from the root or wall of the pulmonary artery（PA）,the retrograde flow into PA in LCA and abundant collateral vessels in myocardium.However the later exhibited normal diameter of LCA and RCA and no collateral vessels.Conclusions Color Doppler echocardiography not only demonstrates left ventricular systolic function,endocardium,mitrial regurgitation and collateral vessels in myocardium,but also shows the origination and courses of LCA clearly,which provide exact informations to diagnose ALCAPA.The echocardiography can be used as a powerful tool of ALCAPA diagnosis and preoperative assessment.

关 键 词：超声心动描记术 心脏缺损 先天性 左冠状动脉起源于肺动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学]