超声心动图诊断膜周部室间隔缺损伴右冠瓣脱垂的可行性  

Feasibility of diagnosis of perimembranous ventricular septal defect with right aortic valve prolapse by ultrasonic echocardiography

作　　者：王树杰[1] 谢兆丰[2] 李珊[2] 李渝芬[2] 谢育梅[2] 张智伟[2] 

机构地区：[1]南方医科大学,广州市510080 [2]广东省人民医院,广东省医学科学院,广东省心血管病研究所,广州市510080

出　　处：《实用医学杂志》2016年第13期2142-2145,共4页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2014A020212675;2015B070701008)

摘　　要：目的:探讨室间隔缺损(VSD)伴主动脉瓣右冠瓣脱垂(AVP)的超声心动图检查的可行性。方法:采用彩色多普勒超声机对131例VSD患儿行经胸超声心动图检查,同期予心导管检查,根据AVP程度,两种检查各自分为4组:未脱垂组、轻度脱垂组、中度脱垂组、重度脱垂组。以心导管造影检查为金标准,评估超声心动图诊断VSD伴主动脉瓣右冠瓣脱垂的可行性。结果:131例患者中,超声诊断"未脱垂组87例、轻度脱垂组14例、中度脱垂组12例、重度脱垂组18例",经心导管造影检查验证,超声未脱垂组阳性率:44.8%;超声轻度脱垂组阳性率42.86%;超声中度右冠瓣脱垂组阳性率58.3%;超声重度AVP组阳性率83.3%。结论:超声心动图可准确评价膜周部VSD伴重度主动脉瓣右冠瓣脱垂,超声心动图对VSD伴轻度右冠瓣脱垂评价能力欠佳,需结合心导管造影检查以明确诊断。Objectives To explore the feasibility ofdiagnosis of Perimembranous Ventricular Septal Defect with Right Aortic Valve Prolapse by ultrasonic echocardiography. Methods 131 VSD patients aged 1 to 22 years, weight 8.0 to 54.0 kg, underwent transthoraeie echoeardiography （TTE） and left vcntricular angiography to show the diameter of VSD and the degree of AVP. Results Among 131 patients, 87 cases were diagnosed as VSD, 14 as VSD with slight AVP, 12 as, VSD with middle AVP, and 18 as VSD with severe AVP by uhrasonic echocardiography respectively. After the left ventricular angiography and aortic root angiography, it proved that positive rate of VSD was 44.8%, positive rate of VSD with slight AVP was 42.86%, positive rate of VSD with middle AVP was 58.3%,and positive rate of VSD with severe AVP was 83.3%. Conclusion The transthoracic echocardiography （TIE） contributes to diagnosis of severe degree of AVP,while TTE evaluates the slight degree of AVP incorrectly enough. Left ventricular angiography and aortic root angiography are needed to realize the di- agnosis of AVP.

关 键 词：超声心动图 室间隔缺损 主动脉瓣脱垂 影像学 

分 类 号：R540.45[医药卫生—心血管疾病] R725.4[医药卫生—内科学]