房室间隔缺损的形态学诊断──二维超声心动图与心血管造影、手术的比较

MORPHOLOGICAL DIAGNOSIS OF ATRIOVENTRICULAR SPTAL DEFECT. TWO DIMENSIONAL ECHOCARDIOGRAPHY, ANGIOCARDIOGRAPHY AND SURGERY CORRELATE

为了评估二维超声心动图（２ＤＥ）对房室间隔缺损（ＡＶＳＤ）的诊断和手术方法选择价值，对８７例ＡＶＳＤ的２ＤＥ、心血管造影及手术结果进行回顾对照研究。病例年龄自３个月至１１岁（平均３．９岁）。部分型ＡＶＳＤ４６例，过渡型１２例，完全型２９例（Ａ型２１例，Ｂ型４例，Ｃ型４例）。２ＤＥ诊断与手术诊断符合率在部分型ＡＶＳＤ中为９７％，在过渡型及完全型ＡＶＳＤ中为８４％。２ＤＥ诊断与手术诊断不符者大多为过渡型与Ａ型之间的交错。２ＤＥ诊断准确率优于心血管造影检查。结果表明，２ＤＥ检查在心尖、剑突下切面中能够清楚显示ＡＶＳＤ的形态改变，获得可靠的形态学诊断。

The selection of operative procedure for repairing atrioventricular septal defect (AVSD)and the results are dependent on completeness and accuracy of preoperative morphological di-agnosis. To evaluate the value of two dimensional echocardiographic(2DE) technique devisedspecifically for morphological diagnosis,the results of 2DE,angiocardiograpny and surgerywere examined retrospectively in 87 children with AVSD. The children’s age ranged from 3months to 11 years old (mean 3.9 years).46 patients had partial AVSD, 12 had transitionalAVSD, and 29 had complete AVSD(type A in 21,type B in 4,type C in4). 2DE diagnosis isconcordant with surgical in 36/37(97%)patients with partial AVSD,in 25/31(84%)patientswith transition or complete AVSD. Most discordant diagnosis between 2DE and surgery oc-curred in patients with transitional or type A AVSD,The 2DE technique for morphologicaldiagnosis of AVSD is superior to angiocardiography. The results indicated that morphologicalmanifestations of AVSD could be clearly demonstrated with use of apical,subxiphoid twodi-mensional imaging planes so that reliable morphological diagnosis could be obtained.