超声心动图在新生儿动脉导管瘤诊断中的应用

Application of echocardiography in the diagnosis of neonatal ductus arteriosus aneurysm

目的 探讨超声心动图对新生儿动脉导管瘤（ductus arteriosus aneurysm,DAA）的诊断价值及临床意义.方法 应用超声心动图技术观察和分析27例新生儿DAA的超声影像学特征及诊断方法,并随访预后.结果 新生儿DAA的超声心动图具有4个重要特征：①高位胸骨旁大动脉短轴观于左肺动脉起始部左侧可见瘤形结构；②追踪该瘤形结构顶端,可见一水平走行的细小分流束自瘤体射向左肺动脉起始部；③沿瘤体走行向后下方追踪,瘤体汇入降主动脉,与主动脉弓分列图像左右两边,呈“V”字型征；④降低彩色多普勒速度标尺,瘤体内显示低速红色血流信号.对27例DAA患儿分别于出生后1个月、3个月行超声心动图随访,除1例患儿在3个月失访外,其余患儿DAA自行消失,心脏形态、大小、收缩舒张功能良好.结论 超声心动图可作为新生儿DAA诊断与随访的重要手段,新生儿DAA多数预后良好.

Objective To investigate the application of echocardiography in the diagnosis of neonatal ductus arteriosus aneurysm （DAA）.Methods A total of 27 neonates with DAA were detected by echocardiography.Echocardiographic features in these cases were explored and outcome of these neonates were followed up.Results There were four crucial features in DAA detected by echocardiography：① A vessel bump was shown on the left side of the origination of left pulmonary artery（LPA） in the high parasternal short-axis view.②A horizontal shunt jet from the bump to the origination of LPA was shown when interrogate the top of the bump.③The bump joined the descending arota when interrogate it down and back orientately.A ‘V＇ shaped sign was shown when the aortic arch appeared on the right side and the bump on the left side.④A slow red flow signal was found in bump when the scale of color Doppler was cut down.The follow-up echocardiography showed spontaneous closure of the DAA when 3 months of age except one case lost.There were no abnormality in the figure and function in heart.Conclusions Echocardiography can be a valuable method for the diagnosis of neonatal ductus arteriosus aneurysm.Neonate with DAA have a good outcome.