肺动脉吊带的超声心动图诊断价值及漏误诊分析  

The diagnostic value and misdiagnostic analysis of pulmonary artery sling by Doppler echocardiography

作　　者：吴力军[1] 张玉奇[2] 高玲玲[1] 陈丽君[2] 王珊珊 

机构地区：[1]上海交通大学医学院附属新华医院超声科,上海200092 [2]上海交通大学医学院附属上海儿童医学中心心内科,上海200127

出　　处：《中国临床医学影像杂志》2015年第10期696-699,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨多普勒超声心动图对肺动脉吊带(PAS)的诊断价值,分析超声心动图漏误诊的原因,提高超声心动图对PAS诊断的准确性。方法 :本文回顾性分析62例经外科手术证实为PAS患儿的超声心动图检查资料。结果 :62例PAS中,完全性PAS 59例,部分性PAS 3例;单纯性PAS 14例,合并其他心血管畸形者48例。62例患儿中,超声诊断正确55例(占88.7%),漏误诊7例(占11.3%)。7例漏误诊患者中,3例超声诊断为左肺动脉缺如,2例诊断为左肺动脉发育不良,1例诊断为原发性肺动脉高压伴三尖瓣轻度反流,1例诊断为法洛四联症、左肺动脉不能显示。62例患者中57例行心脏CT检查,心脏畸形与外科手术发现均相同,诊断符合率100%;CT诊断气道狭窄51例,气道狭窄超声心动图检查均未显示。结论:超声心动图可以比较准确地诊断PAS,但易漏误诊;在正常左肺动脉起始处若未发现左肺动脉,要警惕PAS的存在;必要时应行心脏CT检查,明确诊断及有无气管狭窄存在。Objective： To evaluate the diagnostic value of pulmonary artery sling （PAS） by Doppler echocardiography, and analyze the misdiagnostic reason. Methods： Doppler echocardiography images were compared with surgical findings in 62 PAS children. Results： In 62 cases, 59 cases were complete PAS and 3 cases were partial PAS. Fourteen cases were simple PAS, and 48 cases were accompanied with other cardiovascular anomalies. In 62 cases, 55 cases （88.7%） were diagnosed correctly, 7 cases （11.3%） were misdiagnosed. In misdiagnosed cases, three were diagnosed as left pulmonary artery absence, two were left pulmonary artery dysplasia, one was primary pulmonary hypertension with mild tricuspid regurgitation, and one was tetralo- gy of Fallot with unclear left pulmonary artery. In 62 cases, 57 cases performed cardiac CT, heart abnormalities were same as surgical finding, diagnosed accuracy was 100%. CT diagnosed tracheal stenosis in 51 cases, but was not shown by echocar- diography. Conclusion： PAS can be diagnosed accurately by Doppler echocardiography, but it is prone to be misdiagnosed. PAS might be suspected while left pulmonary artery could not be shown well by Doppler echocardiography, and cardiac CT should be performed to confirm the diagnosis of PAS and tracheal stenosis.

关 键 词：肺动脉 超声心动描记术 多普勒 彩色 体层摄影术 螺旋计算机 

分 类 号：R543.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]