心上型部分性肺静脉异位引流超声诊断及漏误诊原因分析  

Analysis of the causes of echocardiography diagnosis of Supracardiac partial anomalous pulmonary venous connection

作　　者：曹爱梅[1] 李春敏 包敏[1] 郭婧慧 刘波[1] 任军[1] 郑春华[1] 石琳[1] CAO Aimei;LI Chunmin;BAO Min;GUO Jinghui;LIU Bo;REN Jun;ZHENG Chunhua;SHI Lin(Department of Pediatric Cardiology,Children’s Hospital Capital Institute of Pediatrics,Beijing 100010,P.R.China;Department of Ultrasound,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,P.R.China)

机构地区：[1]首都儿科研究所附属儿童医院心内科,北京100010 [2]山东第一医科大学附属省立医院超声科,山东济南250021

出　　处：《医学影像学杂志》2021年第7期1128-1131,共4页Journal of Medical Imaging

摘　　要：目的探讨超声心动图诊断心上型部分性肺静脉异位引流(PAPVC)的诊断价值及分析漏误诊原因。方法选取我院诊断30例心上型PAPVC超声心动图的二维图像、彩色多普勒图像,并与心脏CT、手术结果进行对比分析。结果30例心上型PAPVC患者中,明确诊断19例,提示性诊断3例,漏诊6例,误诊2例。其中22例合并简单先天性心脏病(房间隔缺损、卵圆孔未闭、室间隔缺损、动脉导管未闭等),1例为两支合并共同腔,1例合并双主动脉弓,1例合并三房心,1例合并完全性心内膜垫缺损等复杂畸形,6例为孤立性。结论超声对心上型PAPVC确诊有较高的准确度,但易漏误诊,必要时需CTA协助确诊。Objective To explore the diagnostic value of echocardiography(ECG)for supracardiac partial anomalous pulmonary venous connection(PAPVC),and to analyze the causes of misdiagnosis and missed diagnosis.Methods The echocardiographic characteristics of PAPVC in 30 cases from March 2018 to March 2021 in our hospital were analyzed and compared with the results of cardiac CT and operation.The diagnostic features of echocardiography,reasons of missed diagnosis and misdiagnosis were summarized,in order to provide important information for surgery.Results In 30 cases with PAPVC,19 cases were diagnosed definitely,3 case were suspected,6 cases were missed,2 cases were misdiagnosed.Combined malformations including 22 cases had simple type of congenital heart disease(atrial septal defect,patent foramen ovale,ventricular septal defect,patent ductus arteriosus,etc),1 case had two branches combined with common lumen,1 case had double aortic arch,1 case had cor triatratum,1 case had complete endocardial pad defect and other complex malformations,while 6 cases were isolated.ConclusionEchocardiography has high accuracy in diagnosis of PAPVC,but it is easy to miss diagnosis and misdiagnosis,and CTA assistance needs for diagnosis if necessary.

关 键 词：心上型部分性肺静脉异位引流 误漏诊 超声心动图 

分 类 号：R541[医药卫生—心血管疾病] R445.1[医药卫生—内科学]