经胸超声心动图与CTA对完全性肺静脉异位引流的诊断价值比较  

Comparison of the diagnostic value of transthoracic echocardiography and CTA in total anomalous pulmonary venous connection

作　　者：夏娟[1] 吴梅 王静静 谢姝瑞 王杰[1] 薛艳玲 马小静 XIA Juan;WU Mei;WANG Jingjing;XIE Shurui;WANG Jie;XUE Yanling;MA Xiaojing(Department of Echocardiograph,Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology,Wuhan Clinical Medical Research Center for Cardiovascular Imaging,Wuhan,430022,China)

机构地区：[1]武汉科技大学附属武汉亚洲心脏病医院超声科武汉市心血管影像临床医学研究中心,武汉430022

出　　处：《临床心血管病杂志》2023年第12期930-934,共5页Journal of Clinical Cardiology

基　　金：武汉市科技局知识创新专项(No:2023020201010204)。

摘　　要：目的:比较经胸超声心动图(transthoracic echocardiography, TTE)与CTA对完全性肺静脉异位引流(total anomalous pulmonary venous connection, TAPVC)的临床诊断价值。方法:回顾性分析2016年1月—2022年12月武汉亚洲心脏病医院经手术证实的40例TAPVC患者,包括23例心上型、10例心内型、4例心下型、3例混合型,术前均接受TTE和CTA检查,比较两种检查对TAPVC的诊断价值。结果:对TAPVC整体分型的诊断准确率CTA 95.00%(38/40)高于TEE 70.00%(28/40),差异有统计学意义(P<0.05);本组TAPVC共合并64项心内外合并畸形,TTE和CTA诊断准确率分别为93.75%(60/64)和87.50%(56/64),两者无明显差异(P>0.05);TTE和CTA对于继发的三尖瓣重度关闭不全和肺动脉高压的诊断准确率分别为87.88%(29/33)和18.18%(6/33),TTE高于CTA(P<0.05)。结论:CTA整体分型诊断优于TEE,但两者优势不可相互替代,最佳的选择还是两者联合,为患者提供更加全面和精准的诊断信息,指导临床治疗策略。Objective To compare the diagnostic value of transthoracic echocardiography(TTE) and computed tomography angiography(CTA) in total anomalous pulmonary venous connection(TAPVC).Methods From January 2016 to December 2022, 40 patients with TAPVC in Wuhan Asia Heart Hospital were analyzed, all patients were confirmed by surgery, including 23 cases of supracardiac type and 10 cases of intracardiac type and 4 cases of infracardiac type and 3 cases of mixed type. All cases underwent both TTE and CTA examination.Results The diagnostic accuracy rate of CTA for TAPVC typing was 95.00%(38/40), which was higher than that TTE(70.00%, 28/40), and the difference was statistically significant(P < 0.05);The number of combined extracardial and extracardiac malformations was 64 in all TAPVC cases, the diagnostic accuracy rate of TTE for TAPVC combined malformations was 93.75%(60/64), which was similar to CTA 87.50%(56/64), there was no significant difference(P>0.05). The diagnostic accuracy rates of TTE and CTA for secondary severe tricuspid valve insufficiency and pulmonary hypertension were as follows: 87.88%(29/33), 18.18%(6/33), the accuracy rates of TTE was higher than CTA(P < 0.05).Conclusion The overall classification diagnostic efficacy of CTA is superior to TEE, but the advantages of TTE and CTA cannot be replaced each other. To get more comprehensive and accurate diagnostic information and guide clinical treatment strategy, TTE and CTA should be combined.

关 键 词：完全性肺静脉异位引流 诊断 超声心动描记术 体层摄影术 X线计算机 

分 类 号：R541.3[医药卫生—心血管疾病]