Taussig-Bing综合征彩色多普勒超声心动图特征研究

Study on image characteristics of color Doppler echocardiography on Taussig-Bing syndrome

目的探寻Taussig-Bing综合征(TBS)彩色多普勒超声心动图(CDE)图像特征。方法应用CDE检查15例TBS患者,所有患者均有心血管造影对照,14例经手术证实。结果根据CDE特征表现对13例TBS做出正确诊断,2例误诊为完全性大动脉转位。TBS的CDE图像特征:①二维超声心动图(2DE)胸骨旁左室长轴观显示室间隔回声中断,主动脉在前方发自右心室,肺动脉在后方骑跨在室间隔之上,称2DE“骑跨征”。②2DE胸骨旁大动脉短轴观显示两条大动脉呈两个环状回声,称2DE“双环征”。③根据两环相互位置关系判断大动脉转位的类型;根据两环内径比较判断是肺动脉狭窄还是肺动脉高压。④彩色多普勒血流显像显示过室间隔双向五彩镶嵌分流束血流信号;有肺动脉狭窄患者显示过肺动脉五彩镶嵌射流束血流信号。⑤应用CDE诊断TBS需与完全性大动脉转位和右心室双出口鉴别诊断。结论TBS的CDE图像特征明显,CDE对TBS有特异性诊断价值,可与心血管造影媲美。

Objective To observe the image characteristics of Taussig-Bing syndrome （TBS） on color Doppler echocardiography （CDE）. Methods Fifteen patients with TBS were examined by CDE. All of them underwent angiocardiography and 14 of them were confirmed by operation. Results Thirteen cases were accurately diagnosed by CDE and the other 2 were misdiagnosed as the complete transposition of the great arteries. TBS had obvious image features on CDE： ① The parasternal long axis view of two-dimensional echocardiography （2DE） image showed discontinuous echo of ventricular septal,and the anterior aorta developed from right ventricle while the posterior pulmonary artery straddled on the ventricular septal, which was named 2DE ＂straddle sign＂. ②Parasternal short axis view showed two ring echoes,which was named 2DE ＂double-ring sign＂. ③The type of transposition was estimated according to the relative position of the two rings, and the judgement of pulmonary stenosis or pulmonary hypertension was based on the comparison between the inner diameters of the two rings. ④Color Doppler showed bidirectional multicoloured shunt flow signal through ventricular septal, and for those with pulmonary stenosis, it showed multicoloured jet flow signal through pulmonary artery. ⑤When diagnosed by CDE, TBS should be distinguished from complete transposition of the great arteries and double outlets of right ventricle. Conclusions The features of TBS on CDE were obvious. CDE is valuable and comparable with angiocardiography for diagnosing TBS.