冠状动脉异常起源于肺动脉的超声诊断及误诊分析

Diagnosis value of the anomalous origin of coronary artery from pulmonary artery by echocardiography and analyze the reason of the misdiagnosis

目的:探讨超声心动图在冠状动脉异常起源于肺动脉的诊断价值,并对误诊原因作分析。方法:对超声诊断为冠状动脉异常起源于肺动脉并手术证实的5例病例进行分析。结果:5例冠状动脉异常起源于肺动脉首次正确诊断全部由超声实现,其主要超声特征是:主动脉发出单支扩张冠脉;肺动脉发出异常分支并且血流倒灌;丰富冠脉侧支循环;常伴有左室长期心肌缺血继发表现。3例患者曾经进行超声心动图检查曾误诊为冠状动脉肺动脉瘘。结论:超声心动图诊断冠状动脉起源于肺动脉有非常重要的诊断价值。

Objective To investigate the diagnosis value of the anomalous origin of coronary artery（AOCA） from pulmonary artery by echocardiography,and analyze the reason of the misdiagnosis.Methods To analyze the 5 cases of AOCA from pulmonary artery by echocardiography,proved by surgery.Results Those 5 cases of AOCA from pulmonary artery were firstly diagnosed by echocardiography correctly,whose untrasonographic characteristic were：single dilated coronary arising from aorta,anomalous branches arising from pulmonary artery and the blood regurgitation,abundant coronary artery collateral circulation,often accompanying the secondary manifestation after long-term left ventricular blood defect.3 of the 5 cases were misdiagnosed as coronary-pulmonary fistulae by echocardiography.Conclusion There is very important diagnostic value of echocardiography in anomalous origin of coronary artery from pulmonary artery.