超声诊断右室流出道梗阻的临床价值

Clinical value of ultrasonography in diagnosis of right ventricular outflow obstruction

目的探讨超声对右室流出道梗阻术前诊断的临床价值。方法收集2005年5月～2008年6月在我院行手术治疗的右室流出道梗阻病例92例,用二维超声心动图观察右室流出道的狭窄情况及合并的各类畸形,用彩色多普勒检测右室流出道及合并畸形的血流动力学改变。结果超声诊断右室流出道局限性狭窄66例,弥漫性狭窄25例,肺动脉瓣闭锁1例,与手术结果对照右室流出道狭窄部位、程度相符,超声漏诊永存左上腔静脉2例,卵圆孔未闭3例,房间隔大缺损1例。结论超声检查能准确检测右室流出道梗阻的解剖异常及合并畸形,是术前诊断的首选检查方法,有助于手术方案的选择。

Objective To investigate the clinical value of ultrasonography in diagnosing the outflow obstruction of right ventri- cle. Methods From May 2005 to June 2008,92 patients with right ventricular outflow obstruction and treated by surgery in this hospi- tal underwent two - dimensional echocardiography to assess the degree of the right ventricular outflow tract stenosis and various types of concomitant malformations, and to detect the hemodynamic changes in those patients by color Doppler. Results Ultrasonography re- vealed 66 patients with local stenosis,25 patients with diffuse stenosis, and 1 patient with pulmonary atresia. The positions and degrees of these stenoses detected by ultrasonography were compatible with the findings in operation. But the ultrasound misdiagnosed 2 patients with persistent left superior vena cava,3 patients with patent foramen ovale, and 1 patient with atrial septal defect. Conclusion Ultra- sonography can accurately detect anatomic abnormality and concomitant malformation in patients with right ventricular outflow obstruc- tion diseases. Ultrasonography is the prior method of preoperative examination and can guide in choice of the operation program.