主动脉左室隧道的超声诊断价值及预后分析

Ultrasonographic diagnosis and prognosis of aortic left ventricular tunnel

目的探讨主动脉左室隧道(ALVT)的超声诊断价值,并分析其图像特征,追踪患儿手术结果及预后情况。方法对6例经彩色多普勒超声心动图(CDE)诊断为ALVT的患者进行回顾性分析,并将全部患着的声像图表现与心血管造影、手术结果、术后结果对比分析,并总结其诊断特点。结果 6例经超声心动图诊断为ALVT的患者与心血管造影、手术结果基本符合,ALVT图像特征明显,二维超声心动图胸骨旁左室长轴切面上清晰显示主动脉瓣周至左室流出道的隧道样结构,彩色多普勒血流显像(CDFI)显示收缩期血流信号从左室流出道经隧道进入主动脉,舒张期血流信号由主动脉经隧道进入左室,术后跟踪复查均闭合良好。结论超声心动图诊断ALVT有效、快捷、无创,是诊断ALVT的首选方法,为临床诊断提供了准确可靠的参考依据,并注意与右冠状窦瘤破裂、冠状动脉瘘及主动脉瓣关闭不全等相鉴别。

Objective To explore the value of eehocardiography in the diagnosis of aortic left ventrieular tunnel （ ALVT）, to investigate the uhrasonographic characteristics of ALVT, and to follow up the surgical results and their prognosis. Methods Six patients diagnosed as ALVT by echocardiography were retrospectively analyzed, compared with the angiocardiography and the operation results, and the ultra-sonographic characteristics were summarized. Results The ultrasonographic features of ALVT were obvious, and the diagnosis was basi-cally in accordance with the angiocardiography and the operation results. The two-dimensional echocardiography clearly showed that the non-echo tubal cavity around the aortic valve connected with the left ventricular outflow-tract. Color Doppler flow imaging showed that the blood flow signal from the left ventricular outflow-tract entered into the aorta through the abnormal tunnel during systolic phase, and vice visa during diastolic phase. Conclusions ALVT can be diagnosed accurately by echocardiography,which is an effective, quick, and non-invasive way. But it should be differentiated from the rupture of right coronary aneurysm, coronary artery fistula, and aortic insufficiency.