经胸超声心动图对肺动脉异常起源的诊断价值  

Value of Transthoracic Echocardiography in the Diagnosis of Anomalous Origin of Pulmonary Artery

作　　者：冯云[1] 胡蓉[1] 霍亚玲 王丹[1] Feng Yun;Hu Rong;Huo Yaling;Wang Dan(Department of Ultrasound,Children's Hospital Affiliated to Zhengzhou University,Henan Children's HosipitaL Zhengzhou Children's Hosipital,Zhengzhou»Henan 450000,China)

机构地区：[1]郑州大学附属儿童医院·河南省儿童医院·郑州儿童医院超声医学科,郑州市450000

出　　处：《中国超声医学杂志》2021年第6期710-713,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析经胸超声心动图(TTE)对肺动脉异常起源的诊断价值。方法收集22例肺动脉异常起源患儿的临床资料,所选患儿均行TTE检查,其中16例经手术证实,6例经多层螺旋CT血管成像(MSCTA)证实,回顾性分析TTE的声像图特点及诊断准确率。结果 22例患儿,经手术或MSCTA证实为单侧肺动脉缺如(UAPA)4例,单侧肺动脉异常起源于升主动脉(AOPA) 6例,肺动脉吊带(PAS)12例;术前TTE诊断准确率81.82%(18/22),其中UAPA 4例,表现为主肺动脉及一侧分支清晰显示,多个切面扫查另一侧肺动脉分支均不能显示;AOPA 4例,均为右肺动脉异常起源,表现为主肺动脉分叉消失,于升主动脉可见右肺动脉且合并肺动脉高压(PAH)。TTE误诊为右肺动脉缺如1例,动脉导管未闭(PDA)+重度PAH 1例;PAS 10例,表现为主肺动脉向下延续为右肺动脉,于右肺动脉远端发出左肺动脉。TTE误诊为UAPA 1例,漏诊1例,诊断为原发性PAH。结论 TTE是肺动脉异常起源首选的检查方法,通过多切面扫查观察异常起源的肺动脉及其分支的位置和走行可对其做出明确诊断。Objective To analyze the diagnostic value of transthoracic echocardiography(TTE) for anomalous origin of pulmonary artery. Methods Clinical data of 22 children with abnormal origin of pulmonary artery were collected, and all the selected children underwent TTE examination, among which 16 cases were confirmed by surgery, and 6 cases were confirmed by multi-slice spiral CT angiography(MSCTA), and the ultrasonographic characteristics and diagnostic accuracy of TTE were retrospectively analyzed. Results Among the 22 cases, 4 cases were proved to be unilateral pulmonary artery deficiency(UAPA) by operation or MSCTA, 6 cases were from ascending aorta(AOPA), and 12 cases were from pulmonary artery sling(PAS). Preoperative diagnostic accuracy rate of TTE was 81.82%(18/22). In 4 cases of UAPA, the presentation of the main pulmonary artery and the branch on one side were clearly displayed, and the branch of the pulmonary artery on the other side could not be displayed in multiple sections. All the 4 cases of AOPA were of abnormal origin of right pulmonary artery, presenting the disappearance of bifurcation of the main pulmonary artery, and the right pulmonary artery with pulmonary hypertension(PAH) was seen in the ascending aorta. TTE was misdiagnosed as absence of right pulmonary artery in 1 case, patent ductus arteriosus(PDA)+ severe PAH in 1 case. In 10 cases with PAS, the main pulmonary artery continued downward to the right pulmonary artery, and the left pulmonary artery was emitted at the distal end of the right pulmonary artery. TTE was misdiagnosed as UAPA in 1 case and misdiagnosed in 1 case as primary PAH. Conclusions TTE is the preferred detection method for anomalous origin of pulmonary artery. The position and route of anomalous origin of pulmonary artery and its branches can be clearly diagnosed by multi-section scanning.

关 键 词：经胸超声心动图 计算机体层摄影 肺动脉起源 诊断价值 

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