超声心动图在CPVS诊治中的临床应用

Clinical Application of Echocardiography in the Diagnosis and Treatment of Congenital Pulmonary Vein Stenosis

目的探讨超声心动图在先天性肺静脉狭窄(congenital pulmonary vein stenosis,CPVS)诊治中的临床应用价值。方法应用超声心动图(经胸及术中经食道超声心动图)、双源计算机断层扫描(computed tomography,CT)及外科术中探查对照确定诊断。结果 10例患者中,单纯PVS 1例,合并其它心血管畸形的9例,其中9例行手术治疗,超声诊断与手术完全符合7例。超声发现13支肺静脉狭窄(pulmonary vein stenosis,PVS),CT及手术探查发现17支PVS,其中隔膜样狭窄8支,管样发育不良3支,入口处嵴样狭窄6支。结论超声心动图结合高分辨率多排CT检查能明确诊断PVS,能对手术方式的选择和评估预后起到决定性作用。超声心动图是参与CPVS诊治全过程的重要手段,对其诊断及术后随访、评价预后具有重要意义。

Objective To explore the clinical value of echoeardiography in the diagnosis and treatment of congenital pulmonary vein stenosis. Methods Examination results of echoeardiography （transthoracic echocardiography, intraoper- ative transesophageal echocardiography）, dual-source computed tomography （CT） and surgical exploartion were com- pared. Results In 10 patients, one had simple pulmonary vein stenosis, nine were combined with other cardiovascular malformations, nine underwent surgery and ultrasound diagnosis and surgery were in full compliance in seven eases. Thir- teen cased with pulmonary vein stenosis （PVS） were found by the ultrasound, 17 were found by CT and surgical explora- tion, among which 8 were diaphragm-like stenosis, 3 were tube-like dysplasia, and 6 were the ridge-like narrow entrance. Conclusion Echocardiographic combined with high-resolution multi-slice CT examination can make the definite diagnosis of PVS and play a decisive role in the choice of surgical approach and assessment of prognosis. Echocardiography is an im- portant means during the whole diagnosis and treatment process of CPVS and is of great significance of the diagnois, post- operative follow-up and prognosis assessment.