先天性二尖瓣-主动脉瓣间纤维假性动脉瘤的超声心动图诊断  

Diagnosis of congenital pseudoaneurysm of the mitral-aortic intervalvular fibrosa by echocardiography

作　　者：洪雯静 丁粤粤[2] 张玉奇[1] 吴兰平[1] 金启晨 孙爱敏[3] Hong Wenjing;Ding Yueyue;Zhang Yuqi;Wu Lanping;Jin Qichen;Sun Aimin(Department of Pediatric Cardiology,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Department of Pediatric Cardiology,Children's Hospital of Soochow University,Suzhou 215025,China;Department of Radiology,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心内科,200127 [2]苏州大学附属儿童医院心内科,215025 [3]上海交通大学医学院附属上海儿童医学中心放射科,200127

出　　处：《中华超声影像学杂志》2020年第8期652-656,共5页Chinese Journal of Ultrasonography

摘　　要：目的:分析先天性二尖瓣-主动脉瓣间纤维假性动脉瘤(pseudoaneurysm of the mitral aortic intervalvular fibrosa,PMAIVF)的彩色多普勒超声心动图特征,评价超声对PMAIVF的诊断价值。方法:回顾性分析2008年6月至2020年1月在上海交通大学医学院附属上海儿童医学中心及苏州大学附属儿童医院经CTA、MRI及外科手术证实的4例PMAIVF的超声心动图检查资料。结果:PMAIVF声像图特征为二尖瓣与主动脉瓣间的囊袋样膨出,与左心室流出道交通,收缩期血流进入瘤内,瘤体膨起;舒张期血流返回入左心室,瘤体塌陷。4例患儿中,超声诊断符合3例,误诊为左心房内二尖瓣前瓣根部占位1例。结论:多普勒超声心动图技术可以比较准确地诊断PMAIVF,但容易误诊,需要与主动脉瓣周脓肿、心房内占位、冠状动脉瘘等相鉴别。Objective To review the imaging characteristics and evaluate the diagnostic value of Doppler echocardiography for congenital pseudoaneurysm of the mitral-aortic intervalvular fibrosa(PMAIVF).Methods Between June 2008 and January 2020,4 patients with PMAIVF were diagnosed by CTA,MRI and operative findings in Shanghai Children's Medical Center and Children's Hospital of Soochow University.The echocardiographic characteristics were analyzed retrospectively in these children.Results PMAIVF was characterized by a pulsatile echo-free sac that expanded in systole and collapsed in diastole with to-and-fro blood flow on color and pulsed-wave Doppler echocardiography between the mitral leaflet and the aortic annulus.Three cases were diagnosed correctly,and 1 case was misdiagnosed as left atrial mass.Conclusions PMAIVF can be diagnosed accurately by Doppler echocardiography,but it is prone to be misdiagnosed and must be distinguished from aortic root abscess,atrial mass and coronary artery fistula.

关 键 词：超声心动描记术 多普勒 动脉瘤 假性 二尖瓣 主动脉瓣 

分 类 号：R725.4[医药卫生—儿科] R540.45[医药卫生—临床医学]