全肺静脉异位引流的超声诊断

Diagnosis of total pulmonary venous anomalous drainage by echocardiography and color Doppler flow imaging

目的 探讨超声心动图对全肺静脉异位引流 (TPVAD)的探测方法及其表现特征。方法 应用彩色多普勒超声或声学造影检查 3 7例TPVAD ,其中死亡 7例 ,2 9例经手术或尸检证实。结果 3 7例中心上型TPVAD 2 2例 ,心内型 11例 ,心下型 3例 ,混合型 1例。除混合型超声漏诊外 ,其诊断正确率为 96.6% ( 2 8/2 9)。超声检查无肺静脉回流入左房为诊断该病的特征表现 ,根据分型不同超声心动图有相应改变。本组左房、左室校正值均不同程度缩小 ,以左房较明显 ,右房与左房、右室与左室及肺动脉与主动脉比值均增大。结论 应用超声心动图可确定该病的诊断和大致分型 ,判断肺静脉回流梗阻的有无及预后。

Objective To assess echocardiographic detecting technique and imaging characters of total pulmonary venous anomalous drainage (TPVAD).Methods Thirty seven patients of TPVAD were studied by color Doppler flow imaging (CDFI) or contrast echocardiography.Results Thirty sveen patients included 22 of supracardiac type, 11 of cardiac type, 3 of infracardiac type and 1 of mixed type. Accuracy of diagnosis by echocardiography was 96.6 % (28/29) except for 1 patient of mixed type. No pulmonary venous drainage into left atrium detected by echocardiography was the character of this anomaly,which showed corresponding changes in different types. Corrected dimensions of LA and LV were decreased to different degrees.The ratios of RA to LA, RV to LV and PA to AAO were all increased. Conclusions Echocardiography can be used in diagnosis and approximate classification of TPVAD,in judgement of pulmonary venous drainage block and in prediction of the prognosis of patients.