超声心动图与CT血管成像对完全型肺静脉异位引流的诊断价值  

Value of echocardiography and CT angiography in the diagnosis of total anomalous pulmonary venous connection

作　　者：袁国珍[1] 胡军利[1] 张天义[1] 隋桂玲[1] 范东晨[1] 王少春[1] Yuan Guozhen, Hu Junli, Zhang Tianyi, Sui Gulling, Fan Dongchen, Wang Shaochun(Department of Ultrasound, the Affiliated Hospital of Jining Medical University, Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Jining 272029, Chin)

机构地区：[1]济宁医学院附属医院超声科,山东省心脏疾病诊疗重点实验室,山东济宁272029

出　　处：《中国实用医刊》2018年第8期26-29,共4页Chinese Journal of Practical Medicine

摘　　要：目的对比分析超声心动图和cT血管成像（CTA）对完全型肺静脉异位引流（TAPVC）的诊断价值。方法回顾性分析经手术证实的45例TAPVC患者的超声心动图及CTA资料，所有患者术前均行超声心动图检查，其中34例行CTA检查。比较超声心动图和CTA对TAPVC的诊断价值。结果45例TAPVC患者中心上型25例，心内型14例，心下型2例，混合型4例。超声心动图诊断TAPVC45例，诊断符合率为100％（45／45），4例混合型（均为心内型＋心上型）因超声漏诊部分引流途径导致分型错误，3例诊断为心内型，1例诊断为心上型，超声确切诊断符合率为91．1％（41／45）。CTA诊断TAPVc34例，诊断符合率为100％（34／34），其中30例CTA与超声及手术结果一致，4例混合型CTA诊断正确3例，与手术结果相符，1例混合型CTA诊断心内型，与手术结果不相符，CTA确切诊断率为97．1％（33／34）。结论超声心动图和CTA诊断TAPVC均具有较高的准确性，其联合检查可提高混合型TAPVC的诊断准确率。Objective To compare the value of echocardiography and CT angiography （CTA） in the diagnosis of total anomalous pulmonary venous connection （TAPVC）. Methods Echocardiography and CTA features of 45 patients with TAPVC confirmed by operation were analyzed retrospectively. All the patients un- derwent echocardiography before operation, 34 cases of them underwent CTA. The diagnostic value of echocar- diography and CTA of TAPVC was compared. Results Among the 45 TAVPC patients, there were 25 cases of supra-cardiac type, 14 cases of intra-cardiac type, 2 cases of infra-cardiac type and 4 cases of mixed type. Forty-five cases of TAPVC were confirmed by ultrasonography, and the diagnostic rate was 100% （45/45）, 4 cases of mixed type （ intra-cardiac type ＋ supra-cardiac type） were diagnosed as 3 cases of intra-cardiac type, and 1 case of supra-cardiac type, so the exact diagnostic rate was 91.1% （41/45）. Thirty-four cases of TAPVC were diagnosed by CTA, the diagnostic compliance rate was 100% （34/34）, of which 30 cases had the CTA result consistent with the results of ultrasound, in the 4 cases of mixed type, CTA result was accuracy and was compliant to the surgical result in 3 cases of mixed type, and 1 case was diagnosed as intra-cardiac type, which was not consistent with surgical results, the exact diagnosis rate of CTA was 96.7% （33/34）. Conclusions Both echocardiography and CTA have high accuracy in diagnosis of TAPVC, and echocardio- graphy combined with CTA can improve the diagnostic accuracy of mixed TAPVC.

关 键 词：完全型肺静脉异位引流 超声心动图 血管造影术 

分 类 号：R540.45[医药卫生—心血管疾病] R543.2[医药卫生—内科学] R816.2[医药卫生—临床医学]