彩色多普勒血流显像对心房间隔缺损诊断的评价

Evaluation of the Diagnosis of Atrial Septal Defect Using Color Doppler Flow Imaging

目的：探讨彩色多普勒超声心动图诊断心房间隔缺损的临床价值。方法：以彩色多普勒血流显像技术对７５例患者的心房间隔缺损定位及估测缺损大小，并测定肺动脉收缩压。结果：７５例患者中，５２例经手术证实。彩色多普勒超声心动图诊断心房间隔缺损的敏感性达１００％；对缺损的定位准确率为９４．２％（４９／５２）；对缺损大小的估测与手术结果呈显著正相关（ｒ＝０．９５，Ｐ＜０．００１）。对Ｍ型超声心动图显示疑有肺动脉高压的２３例患者用三尖瓣反流压差法估测的肺动脉收缩压与心导管测值密切相关（ｒ＝０．８８，Ｐ＜０．００１）；同时计算肺动脉与主动脉根部内径比值与心导管测值比较，发现肺动脉与主动脉根部内径比值≥１．３５，提示肺动脉高压。结论：彩色多普勒超声心动图对心房间隔缺损有术前诊断价值，并能评价手术效果，可替代有创性检查。

Objective:To study the clinical value of color Doppler flow imaging(CDFI)in the diagnosis of atrial septal defect(ASD). Methods:Location and size of ASD and pulmonary pressure of 75 patients were determined by CDFI. Results:Fifty two of 75 patients with ASD were operated on and confirmed.The diagnostic accuracy and correct localization rate were 100% and 94.2%(49/52)respectively.The size of the evaluated defect correlated well with that seen in the operation (r=0.95,p<0 001). In 29 cases with suspected pulmonary hypertension(PH),pulmonary systolic pressure(PSP),internal diameter of pulmonary artery (PAD) and aorta root (ARD) were measured by M mode echocardiography (PSP by transtricuspid pressure difference method)and cardiac catheterization.The results showed that values of PSP measured by both methods had good correlation( r=0 88,p<0 001) and patients with PAD/ARD more than 1.35 were complicated by PH. Conclusion:CDFI may be used to replace the invasive examinations in the diagnosis of ASD.