超声检查冠状动脉起源异常的漏诊、误诊原因分析

The Analysis of Misdiagnosis or Missed Diagnosis for Coronary Artery Origin Anomalies by Echocardiography

目的分析超声心动图检查先天性心脏病冠状动脉起源异常的误诊、漏诊原因.方法应用彩色多普勒对8例患者进行超声心动图检查,观察左、右冠状动脉主干的起源部位、走行、血流方向,测量冠状动脉主干内径、评价左室功能,观察合并的其他心血管畸形及瓣膜反流情况,并与冠状动脉造影、64排双源CT及手术结果进行对比.结果 8例冠状动脉异常起源患者超声心动图确诊5例,漏诊2例,误诊1例.结论提高诊断意识、注意全面扫查,改善检查技巧并总结诊断经验有助于提高冠状动脉起源异常的诊断和减少误诊漏诊.

Objective To investigate the reasons of misdiagnosis or missed diagnosis by echocardiography in diagnosis of coronary artery origin anomalies.Methods We used color Doppler to examine echocardiography of 8 patients with coronary artery origin anomalies,observed the origin,courser,and blood flow direction of left and right main coronary artery,measured the internal diameter of main coronary artery,evaluated the function of left ventricle,observed concomitant other cardiovascular abnormalities and valvular regurgitation,and compared with the results of coronary arteriongraphy,dual source 64 slices spiral CT,and operations.Result All 8 cases were comfirmed by operations and dual source 64 slices spiral CT,including 5 cases of correct diagnosis,2 cases of missed diagnosis,and 1 case of misdiagonsis with echocardiography examination.Conclusion Strengthening diagnostic consciousness,noting check-over,improving examination skills contribute to reduce misdiagnosis or missed diagnosis by Echocardiography in diagnosis of coronary artery origin anomalies.