超声心动图胸骨上窝探测右肺动脉内病变的临床价值研究

Suprasternal notch echocardiography determination of right pulmonary artery lesions

目的探讨胸骨上窝右肺动脉（RPA）长轴观检查RPA病变的临床应用价值。方法对31例临床怀疑肺血管病患者行常规超声心动图检查，并利用胸骨上窝切面探测RPA，显示RPA主干和右上肺动脉、右下肺动脉近端。观察管壁、管腔内回声及病变所在位置。彩色多普勒血流显像显示肺动脉内血流充盈情况。结果与肺血管CT造影（cTPA）及临床诊断对照。结果31例患者中胸骨上窝切面发现RPA内病变27例，4例显示受限。其中22例显示RPA内有中等回声或低回声团块，5例显示RPA内膜增厚并管腔狭窄、闭塞。检出的27例病变中，20例病变位于RPA主干，7例位于RPA远端及分支。与CTPA对照，25例一致，6例不一致。结论胸骨上窝切面可清晰显示RPA管腔及其分支病变，是诊断肺血管病变方法的重要补充。

Objective To evaluate the value of suprasternal long axis view in echocardiography for right pulmonary artery （RPA） lesions. Methods Echocardiography was performed in 31 patients with clinical suspicion of pulmonary vascular disease. Through suprasternal long axis view, RPA, right superior pulmonary artery and right inferior pulmonary artery were identified, and the vessel wall, intraluminal echoes,and location of the lesion were obtained. Blood flow in pulmonary artery was detected with color Doppler flow imaging. The results of echocardiography were compared with those of computer tomography of pulmonary angiography （ CTPA ） and clinical diagnosis. Results With suprasternal notch eehocardiography,RPA lesions were identified in 27 patients. However, RPA could not be clearly identified in four patients. There were 22 patients with moderate or low echo mass in RPA, and five patients with intimal thickening and artery stenosis/obliteration. In the 27 patients with detected lesions,20 lesions were located in RPA,seven lesions were located in distal RPA or its branches. Among the results obtained with echocardiography,25 were in accordance with CT results, 6 were not in accordance with CT results. Conclusions The suprasternal long axis view of RPA can be an important alternative imaging modality in identification of pulmonary vascular diseases.