房间隔完整的部分型肺静脉异位引流的超声心动图综合诊断  

The comprehensive diagnosis of partial anomalous pulmonary vein connection with intact atrial septum with echocardiography

作　　者：宋家光 张楠 邓焕君 刘爱芹 冯娟 SONG Jiaguang;ZHANG Nan;DENG Huanjun;LIU Aiqin;FENG Juan(Department of Medical Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, P.R.China;Department of Ultrasound, Maternal and Child Health Care Hospital of Dongchangfu District in Liaocheng, Liaocheng 252000, P.R.China;School of Information Science and Engineering, Qilu Normal University, Jinan 250013, P.R.China)

机构地区：[1]山东第一医科大学附属省立医院超声医学科,山东济南250021 [2]山东省聊城市东昌府区妇幼保健院超声科,山东聊城252000 [3]齐鲁师范学院信息科学与工程学院,山东济南250013

出　　处：《医学影像学杂志》2021年第8期1306-1309,1314,共5页Journal of Medical Imaging

基　　金：山东省自然科学基金重点项目(编号:ZR2020KF036)。

摘　　要：目的探讨房间隔完整的部分型肺静脉异位引流(PAPVC/IAS)患者超声心动图(TTE)的综合诊断要点。方法选取15例经外科手术或CT血管造影(CTA)诊断为PAPVC/IAS的TTE特征及检查切面,总结该类疾病的综合诊断思路。结果PAPVC/IAS患者的左心房肺静脉开口均少于4支,异位引流的肺静脉或直接连于右心房或通过体静脉间接回流至右心房。其中心上型7例(46.7%)、心内型5例(33.3%)、心下型2例(13.3%)、混合型1例(6.7%)。结论超声检查中不明原因的右心增大、肺动脉扩张、肺动脉压力增高且房间隔连续完整的患者,应考虑PAPVC/IAS的可能。在常规检查的基础上,增加不同体位、检查部位,采用连续追踪和重点切面相结合的肺静脉观察方法,可以提高PAPVC/IAS的诊断检出率。Objective To evaluate the diagnostic criteria of echocardiography in patients with partial anomalous pulmonary vein connection with intact atrial septum(PAPVC/IAS).Methods The echocardiographic features and the experience of section manipulation were compared retrospectively in 15 patients with PAPVC/IAS,which were diagnosed through the operation of cardial surgery and computed tomography angiography findings.Results PAPVC/IAS was characterized by less than four pulmonary veins returned directly to the left atrium,and the anomalous pulmonary veins connected to the right atrium or indirectly through a variety of venous connections from a pulmonary vein to a systemic vein.There were 7 cases(46.7%)of supracardiac PAPVC,5 cases(33.3%)of cardiac,2 cases(13.3%)of infracardiac,and 1 case(6.7%)of mixed type.Conclusion PAPVC/IAS should be considered in patients with unexplained right ventricular enlargement,pulmonary artery dilatation,pulmonary hypertension as well as with the intact atrial septum.PAPVC/IAS could be diagnosed accurately by adding different body positions and examination sites,and adopting the method of continuous tracking combined with important section observation on the basis of routine examination.

关 键 词：部分型肺静脉异位引流 房间隔完整 超声心动图 

分 类 号：R543.2[医药卫生—心血管疾病] R445.1[医药卫生—内科学]