彩超与左室造影对室间隔缺损并膜部瘤介入封堵术前的临床价值

Clinical value of color Doppler flow imaging and left ventricular angiography in the diagnosis of VSD with aneurysms before interventional occlusion

目的:探讨彩色多普勒血流显像(CDFI)与左室造影对室间隔缺损(VSD)并膜部瘤介入封堵术前的应用价值。方法:用CDFI与左室造影两种方法,对27例VSD并膜部瘤患者在行介入封堵术前进行检查,分别观察VSD并膜部瘤的位置、大小,膜部瘤的形态及距主动脉瓣环、三尖瓣环的距离,术前两种方法进行对比分析。结果:CDFI对VSD并膜部瘤的检出率为92.6%,左室造影的检出率为100%,二者有显著性差异(P<0.05)。CDFI与左室造影对VSD口的大小测量基本一致,无显著性差异。但对VSD并膜部瘤的VSD上缘距主动脉瓣环的距离测值有显著性差异(P<0.05)。结论:CDFI对人体无损伤,重复性好,在VSD并膜部瘤介入封堵术前可提供较准确的依据,与左室造影相关性良好,有重要价值。

Objective：To explore the diagnostic value of color Doppler flow imaging（CDFI） and left ventricular angiography in the diagnosis of ventricular septal defect（VSD） with aneurysms.Methods：Twenty-seven cases of VSD with aneurysms were confirmed by CDFI and left ventricular angiography.Before occlusion the size and the type 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 92.6% via CDFI.The detection rate of the types and the size of membranous aneurysm via CDFI and that via left ventricular angiography had significant difference（P0.05）.The two methods in the measurement of the orifice of VSD had no significant difference but in the measurement of the distance from VSD upper margin to the ring of aortic valve had significant difference（P0.05）.The diameter of occluder waist was significantly correlated with the size measured by CDFI or angiography.Conclusion：There was a positive correlation between CDFI 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.