先天性右心房畸形的超声心动图诊断  

Diagnosis of congenital malformations of the right atrium by echocardiography

作　　者：吴力军[1] 张玉奇[2] 陈亚青[1] 陈丽君[2] 张志芳[2] Wu Lijun Zhang Yuqi Chen Yaqing Chen Lijun Zhang Zhifang(Department of Echocardiography, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092,Chin)

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

出　　处：《中华超声影像学杂志》2017年第9期759-763,共5页Chinese Journal of Ultrasonography

摘　　要：目的分析先天性右心房畸形（congenital malformations of the right atrium，CMRA）的彩色多普勒超声心动图特矸，评价多普勒超声心动网对CMRA的诊断价值。方法回顾性分析11例经心外科手术诊断为CMRA患者的超声心动图资料。结果CMRA声像图特征为右心房或有心耳明显扩张，右心房壁及冠状静脉窦管腔憩室形成。本组原发性右心房扩张4例，右心房憩室3例，原发性右心耳扩张2例，冠状静脉窦憩室2例。本组单纯性CMRA3例，合并其他心血管系统畸形8例，其中卵圆孔未闭6例，房间隔缺损3例，肺动脉高压3例，三尖瓣发育小2例。11例患儿中，超声诊断符合8例（72．7％），误诊3例（27．3％），其中1例原发性右心房扩张误诊为三尖瓣下移畸形，1例右心房憩室误诊为原发性右心耳扩张，1例冠状静脉窦憩室误诊为冠状静脉窦开VI狭窄。结论多普勒超声心动图技术可以比较准确地诊断先天性右心房畸形的各种病变，但容易误诊，需要与三尖瓣下移畸形进行鉴别。Objective To review the imaging characteristics and evaluate the diagnostic value of echocardiography for congenital malformations of the right atrium （CMRA）. Methods Doppler echocardiography was performed and these images were compared with operative findings in 11 children with CMRA. Results CMRA was characterized by idiopathic dilation of the right atrium and right heart appendage, congenital diverticulum of the right atrium and coronary sinus. CMRA consisted of idiopathic dilation of the right atrium （4 cases）, congenital diverticulum of the right atrium（3 cases）, idiopathic dilation of the right heart appendage （2 cases）, and congenital diverticulum of the coronary sinus （2 cases）. The associated malformations included patent foramen ovale （6 cases）, atrial septal defect （3 cases）, pulmonary hypertension （3 cases）, and hypoplastic tricuspid valve （2 cases）. Eight of 11 cases were diagnosed correctly, and other 3 cases were misdiagnosed, in which 1 case with idiopathic dilation of the right atrium misdiagnosed as Ebstein＇s anomaly, 1 case with congenital diverticulum of the right atrium misdiagnosed as congenital enlargement of the right atrial appendage, and 1 case with congenital diverticulum of the coronary sinus misdiagnosed as coronary sinus stenosis. Conclusions CMRA could be diagnosed accurately by Doppler echocardiography, but it is prone to be misdiagnosed and must be distinguished from Ebsteinls anomaly.

关 键 词：超声心动描记术 多普勒 先天性右心房畸形 

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