彩色多普勒超声心动图诊断冠状动脉起源异常的价值

Value of color Doppler echocardiography in diagnosing anomalous origin of coronary artery

目的 探讨彩色多普勒超声心动图在诊断冠状动脉起源异常中的价值。方法 应用彩色多普勒超声心动图对 6例患者进行检查 ,观察左、右冠状动脉主干的起源部位、走行、血流方向 ,测量冠状动脉主干内径、左室射血分数 (LVEF) ,观察合并的其他心血管畸形及瓣膜反流情况 ,并与冠状动脉造影、手术结果进行对比。结果 4例左冠状动脉主干起源于肺动脉 ,1例左前降支起源于肺动脉 ,1例副冠状动脉起源于肺动脉。主要合并的心血管畸形有室间隔缺损、房间隔缺损、完全性心内膜垫缺损等。超声心动图诊断结果与冠状动脉造影及手术探查结果完全符合。超声心动图测量的左、右冠状动脉内径和LVEF与冠状动脉造影测值间高度相关(r分别为 0 .94、0 .96、0 .89,均 P <0 .0 1) ,两种方法测值间差异无显著性意义 (P >0 .0 5 )。结论 彩色多普勒超声心动图可明确诊断冠状动脉起源异常 。

Objective To explore the diagnostic value of color Doppler echocardiography in the patients with anomalous origin of coronary artery.Methods Six patients were studied using color Doppler echocardiography.The origin sites,running courses,blood flow directions of coronary arteries, other accompanied cardiovascular abnormalities and valvular regurgitations were investigated.The diameters of coronary artery trunks and left ventricular ejection fraction (LVEF) were measured.And the results were compared with those of coronary angiography and surgery.Results Left coronary artery(LCA) originated from pulmonary artery(PA) in 4 cases,left anterior descending(LAD) branch originated from PA in 1 case,and accessory coronary artery originated from PA in 1 case.The main accompanied cardiovascular abnormalities included ventricular septum defect,atrial septum defect,complete endocardial cushion defect,and so on.For all the patients,the diagnostic results by echocardiography were consistent with catheterization and surgery.High correlations existed between echocardiographic and catheterization measurements for left and right coronary artery diameter and LVEF (r= 0.94 , 0.96 , 0.89 ,respectively,all P< 0.01 ),both methods showed no significance in the measurement(P> 0.05 ).Conclusions Color Doppler echocardiography can accurately diagnose the patients with anomalous origin of coronary artery, provide reliable information for surgical treatment.