经胸超声心动图和心脏多层螺旋CT在儿童部分性肺静脉异位引流诊断中的价值  

Value of transthoracic echocardiography and cardiac multi - slice spiral computed tomography in the diagnosis of partial anomalous pulmonary venous connection in children

作　　者：朱涛[1] 张智伟[1] 王树水[1] 钱明阳[1] 谢兆丰[1] 罗海营[1] 

机构地区：[1]广东省心血管病研究所,广东省人民医院,广东省医学科学院心儿科,广州510080

出　　处：《中华实用儿科临床杂志》2015年第11期828-831,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的对比分析经胸超声心动图（TTE）及心脏多层螺旋CT（MSCT）在儿童及青少年部分性肺静脉异位引流（PAPVC）诊断中的价值。方法回顾性分析2008年2月至2014年4月广东省人民医院TTE和／或心脏MSCT诊断为PAPVC101例患儿的临床资料，患儿均行常规TTE检查，其中74例完善了心脏MSCT检查，最终与术后所见进行对照，分别计算TTE、心脏MSCT及TTE联合MSCT诊断PAPVC的敏感性。采用SPSS13．0软件进行数据处理。结果101例拟诊断为PAPVC的患儿均完善了TTE检查，同时完善了心脏MSCT检查74例，最终手术确诊93例，8例误诊为PAPVC。TTE诊断68例，诊断敏感性为73．12％（68／93例）；心脏MSCT诊断65例，诊断敏感性为94．20％（65／69例）；TTE联合MSCT检查诊断66例，漏诊2例，诊断敏感性为97．06％（66／68例）。结论在PAPVC诊断敏感性方面，心脏MSCT优于TTE，TTE联合心脏MSCT对绝大多数PAPVC可以做出正确诊断。结合儿童声学窗口特点，除常规胸骨旁切面探查肺静脉外，应重视胸骨上窝及剑突下切面。Objective To make a comparison of transthoracic echocardiography （TI^E） and cardiac multi - slice spiral computed tomography （MSCT） in the diagnosis of partial anomalous pulmonary venous connection （PAPVC） in children. Methods One hundred and one patients admitted from February 2008 to April 2014 in Guang- dong General Hospital primarily diagnosed with PAPVC with or without other congenital heart diseases were analyzed retrospectively, all the cases underwent routine TFE ,which 74 cases underwent cardiac MSCT examination, and the TEE and cardiac MSCT diagnosis results were compared with final surgical findings, then the TIlE and cardiac MSCT diagno- sis accuracy was calculated. SPSS 13.0 software was used to analyze the data. Results All the patients underwent TTE examination,meanwhile,74 cases received cardiac MSCT examination. Ninety -three cases were confirmed by surgical findings, while 8 cases were misdiagnosed with PAPVC. Sixty - eight cases diagnosed by TIlE coincided with surgical findings,and the diagnosis accuracy was 73.12% （68/93 cases） ;65 cases diagnosed by cardiac MSCT coincided with surgical findings, and the diagrlosis accuracy was 94.20% （65/69 cases）. Among the patients who received both TI＇E and cardiac MSCT examinations ,66 cases were confirmed through final surgical operation,2 cases were mis-diagnosis, so the diagnosis accuracy was 97.06% （66/68 cases）. Conclusions In terms of the diagnosis accuracy of PAPVC, cardial MSCT examination is superior to rITE, as almost all of the cases could be diagnosed by TTE combined with car- dial MSCT. In consideration of the acoustics window of children, apart from the conventional parasternal approach of de- tecting pulmonary veins,the importance of suprasternal and subcostal views should also be attached.

关 键 词：部分性肺静脉异位引流 诊断 超声心动描记术 体层摄影术 X线计算机 

分 类 号：R726.5[医药卫生—儿科]