房间隔缺损影像学诊断对比分析

Comparison on the image diagnosis of arterial septal defect

【目的】探讨房间隔缺损的X线、B超及MRI表现特征,为临床医生提供综合可靠的影像资料。【方法】搜集我院收治的184例房间隔缺损患者的X线、B超、MRI影像资料,结合文献对其影像学表现做回顾性比较分析。【结果】术前X线、B超及MRI检查对本组184例房缺患者的阳性诊断率各有不同,其中全心增大为6.52%、9.24%与7.02%,单纯右房增大为18.48%、19.57%与15.79%,右房、右室增大为59.78%、53.26%与49.12%,右房、左房增大为6.52%、4.89%与7.02%。术后随访显示,ASD中继发孔型占87.5%,静脉窦型占5.98%,冠状窦型占4.89%,原发孔型占1.63%;而合并畸形中三尖瓣关闭不全占23.91%,动脉导管未闭占6.52%,左上腔静脉占2.72%,二尖瓣关闭不全占1.63%,肺动脉狭窄占5.98%。【结论】X线平片主要用于观察ASD的心脏外形大小形态和手术前后对比观察肺血管改变;彩色超声心动图能够准确的探明缺损的部位、大小、分流,肺动脉压力及合并畸形;MRI不仅能观察ASD缺损部位大小和各房室大小,而且还可观察肺血情况。

[Objective] To explore the manifestation of the arterial septal defect （ASD） in X-ray, B-ultrasound and magnetic resonance imaging （MRI） for providing reliable imaging data for physicians. [Methods] The imaging data of 184 patients with arterial septal defect in our hospital were collected, and the manifestation in X-ray, B-ultrasound and MRI were retrospectively analyzed. [Results] All patients received X-ray and B-ultrasound examinations before operation, but only 87/184 patients had MR! examination. Among these cases, the various percentage of the size of cardiac atrium or ventricle were calculated. The percentages with complicated monstrosity were also calculated. [Conclusion] X-ray is commonly used to observe the shape and size of ASD and compare the change of lung vasculature before and after the operation. Colour ultrasonic cardiogram may clearly define the position, size and shunt of ASD, the pressure of pulmonary artery, and the complicated monstrosity. MRI can observe not only the size of ASD and cardiac atrium or ventricle, but also the blood circulation of lung.