超声探讨部分性肺静脉异位引流的诊断价值

Echocardiographic diagnosis of partial anomalous pulmonary venous connection

目的:研究超声诊断部分性肺静脉异位引流(PAPVC)的方法。方法:常规超声心动图检查发现右心容量负荷增加时,检查4支肺静脉与左心房的连接,进一步检查上、下腔静脉和右心房等处寻找肺静脉异位引流口,超声检查与手术结果相对照。结果:37例手术证实PAPVC患儿中超声确诊30例,超声漏诊7例,检出率81.08%。37例PAPVC患儿均有不同程度的右心扩大。PAPVC合并房间隔缺损(ASD)34例,无ASD 3例。37例PAPVC中心上型7例,心内型28例,心下型2例。结论:超声显示右心容量负荷过重与心内畸形不相符时,需考虑PAPVC。超声不能完全显示4支肺静脉时,需要检查上、下腔静脉和右心房等处的肺静脉异位引流口。

Objective： To investigate partial anomalous pulmonary venous connection（PAPVC） with echocardiography. Methods： The right ventricular volume overload was detected by routine echocardiography in 37 child patients,who underwent further echocardiography to find the abnormal locations of pulmonary vein opening at superior,inferior vena cava and right atrium.The ultrasound results were compared with surgical findings. Results： In 30 patients the ultrasound diagnosis was consistent with surgery results,7 were misdiagnosed by ultrasound with a detective rate of 81.1%.All 37 PAPVC patients presented varying degrees of right heart enlargement;PAPVC combined with atrial septal defect（ASD） was found in 34 cases. Conclusions： The possibility of PAPVC should be considered when unexplained right heart volume overload was detected by echocardiography.Superior,inferior vena cava and right atrium should be inspected when the pulmonary veins were not seen in echocardiography.