经胸超声心动图诊断右肺动脉起源于升主动脉的价值  

Value of transthoracic echocardiography in the diagnosis of right pulmonary artery originating from the ascending aorta

作　　者：赵丽[1] 王庆慧[1] 罗庆祎[1] 苏璇[1] 陈剑[1] 丁云川[1] ZHAO Li;WANG Qinghui;LUO Qingyi;SU Xuan;CHEN Jian;DING Yunchuan(Department of Ultrasound,the Affiliated Yan'an Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学附属延安医院超声医学科云南省心血管疾病重点实验室,昆明市650000

出　　处：《临床超声医学杂志》2020年第7期532-534,共3页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81460268);云南省卫生科技计划项目(2017NS331)。

摘　　要：目的探讨经胸超声心动图(TTE)对右肺动脉起源于升主动脉(AORPA)的诊断价值。方法回顾性分析11例经手术或CTA确诊的AORPA患者的影像学资料,探讨TTE对AOPRA的诊断及随访价值。结果11例AORPA患者,TTE术前确诊10例,漏诊1例,诊断符合率90.9%。TTE直接表现为主肺动脉分叉消失,右肺动脉异常起源于升主动脉;间接表现为中至重度肺动脉高压。所有病例的异常起源部位均为近端型,多合并其他心脏畸形(动脉导管未闭9例,右肺动脉狭窄2例,室间隔缺损2例,房间隔缺损或卵圆孔未闭4例,部分性肺静脉异位引流1例,主动脉瓣狭窄1例)。10例患者接受外科手术,1例因阻力性肺动脉高压未行手术治疗。10例患者术后随访:9例吻合口通畅,1例右肺动脉狭窄。结论在AORPA的临床诊断及随访中,TTE是首选的简单有效的检查手段,具有较好的应用价值。Objective To investigate the value of transthoracic echocardiography(TTE)in the diagnosis of anomalous origin of the right pulmonary artery from the ascending aorta(AORPA).Methods Eleven cases of AORPA diagnosed by operation or CTA were analyzed retrospectively,and the value of TTE in the diagnosis and follow-up of AORPA was discussed.Results Ten cases were diagnosed clearly while 1 case was missed by TEE before surgery,the diagnostic coincidence rate was 90.9%.The direct manifestations of TEE was the main pulmonary artery bifurcation disappeared and the abnormal right pulmonary artery originated from the ascending aorta.The indirect manifestations was moderate to severe pulmonary hypertension.In all cases,the origin of the abnormality was proximal type,which was mostly associated with other cardiac malformations(9 cases with patent ductus arteriosus,2 cases with right pulmonary artery stenosis,2 cases with ventricular septal defect,4 cases with atrial septal defect/patent foramen ovale,1 case with partial anomalous pulmonary venous connection and 1 case with aortic valve stenosis).The surgery was performed in 10 cases with AORPA,and 1 case had not operated due to severe pulmonary hypertension.Postoperative follow-up of the 10 patients:anastomotic patency in 9 cases and right pulmonary artery stenosis in 1 case.Conclusion TTE plays an important role in the non-invasive and accurate diagnosis for clinical diagnosis and follow-up of AORPA,which indicates a good value in clinical application.

关 键 词：超声心动描记术 肺动脉起源异常 诊断价值 

分 类 号：R540.45[医药卫生—心血管疾病]