彩色多普勒超声心动图诊断右室双出口的价值

Value of color Doppler echocardiography in diagnosis of double outlet right ventricle

目的探讨彩色多普勒超声心动图诊断右室双出口(DORV)的价值。方法分析50例经手术证实为DORV的彩色多普勒超声心动图表现。结果超声诊断准确率98%(49/50),1例误诊为法洛氏四联症。DORV分型超声诊断准确率98%(48/49),1例心房正位、心室左袢、大动脉左转位误诊为心房正位、心室右袢、大动脉左转位,合并畸形83个,心内合并畸形75处,超声漏诊1例肌部室缺,诊断准确率98.7%,心外畸形8处,超声漏诊2处,分别为左上腔静脉异位回流至左房1例,右肺动脉中断1例,超声诊断准确率75%。结论彩色多普勒超声心动图对DORV定性、分型、心内合并畸形诊断具有确诊价值,心外合并畸形诊断具有参考价值,需联合多排螺旋CT检查,可替代创伤性心导管造影。

Objective To explore the value of color Doppler echocardiography （CDE） in diagnosis of double outlet right ventricle （DORV）. Methods Fifty patients with DORV were confirmed by surgery. Their echocardiographic manifestations were analyzed. Results The diagnostic accuracy in DORV by CDE was 98% （49/50）, and 1 case was misdiagnosed as Tetralogy of Fallot. The diagnostic accuracy in types of DORV was 98%（48/49） ,and 1 case SLL was misdiaguosed as SDL. There were 83 accompanied malformations. There were 75 intracardiac malformations, 1 case of muscular ventricular septal defect was missed by CDE, the diagnostic accuracy was 98.7%. There were 8 extracardiac malformations, 1 case of left superior vena cava draining into left atrium and 1 case of interrupted right pulmonary artery were missed by CDE, the diagnostic accuracy was 75%. Conclusion CDE has a great value in diagnosis of DORV and defining its types. It is an accurate, noninvasive and initial method in diagnosis of DORV.