室间隔缺损合并膜部瘤介入封堵前彩超与左室造影的临床应用价值比较

Comparison of the Diagnostic Value of Echocardiography and Angiography in the Occlusion of VSD with Aneurysms

【目的】评价彩色多普勒超声心动图以及左室造影反映室间隔缺损(VSD)合并膜部瘤情况的准确性,提高VSD介入封堵的成功率。【方法】行VSD介入封堵的38例VSD合并膜部瘤患者术前经胸彩色多普勒超声心动图及左室造影检查,分别观察VSD的位置、大小、膜部瘤形态以及观察VSD与主动脉瓣环、三尖瓣的距离;并将结果进行对照分析。【结果】左室造影对室缺合并膜部瘤的检出率为100%,彩超的检出率为94.8%,两者差异有显著性(P<0.01);彩超对各分型的检出率以及测量左室面缺损大小与左室造影结果无显著差异,但对VSD残端与主动脉瓣距离测值的差异有显著性(P<0.05);术后封堵器腰部大小与术前测值相关性良好。【结论】彩超对先天性心脏病VSD合并膜部瘤的观察与左室造影相关性良好,可为临床介入封堵治疗提供较准确的依据,具有重要价值。

[Objective]To evaluate the diagnostic value of color doppler echocardiography and left ventricular angiography in ventricular septal defect（VSD） with aneurysms. [Methods]Thirty eight cases of VSD with aneurysms were confirmed by echocardiography and left ventricular angiography. Before occlusion,the size and the types of membranous aneurysm, distance from VSD to the aortic valve or tricuspid valve were measured. The diameter of occluder waist was measured after occlusion. [Results]The detection rate of membranous aneurysm was 100% via left ventricular angiography and 94.8% via echocardiography. The detection rate of the types and the size of membranous aneurysm via echocardiography was no significant difference with via left ventricular angiography. The distance from VSD to the aortic valve measured by echocardiography was significantly different with that measured by angiography. The diameter of occluder waist was significantly correlated with the size measured by echocardiography or angiography. [Conclusion]There was a positive correlation between echocardiography and left ventricular angiography in estimating membranous aneurysm before occlusion of VSD. They possess very important value in the transcatheter closure of VSD with membranous aneurysm.