经外周静脉超声造影对肺动静脉瘘的诊断价值

The Diagnostic Value of Contrast-enhanced Ultrasound in Pulmonary Arteriovenous Fistula

目的评价经外周静脉超声造影对肺动静脉瘘的诊断价值。方法回顾性分析2010年1月~2015年12月在我院导管室和心外科被诊断为肺动静脉瘘的15例患者的相关临床和影像学资料,采用常规超声和经经外周静脉超声造影检查,观察左右心房、心室和肺动静脉血流情况。结果常规超声心动图显示：15例各房、室腔内径正常,各心瓣膜形态、活动正常,心腔与大动脉连续正常,房、室间隔无回声中断现象,彩色多普勒心腔内未见异常交通血;2例右肺静脉较粗;1例主动脉瓣少量返流;1例肺动脉略增宽。超声造影显示：注入造影剂后右房、右室显影,4~5个心动周期后左房显影,并可看到造影微泡从肺静脉涌入左房,而非房、室穿隔微泡,之后造影微泡迅速进入左心房和左心室,15例均提示肺动静脉瘘。结论经外周静脉超声造影对肺动静脉瘘具有很高的诊断价值。

Objective To evaluate the peripheral intravenous contrastenhanced ultrasound diagnostic value for pulmonary arteriovenous fistula. Methods Retrospective analyzed 15 patients were associated with clinical and radiographic data from January 2010 to December 2015 in our hospital international and cardiac pulmonary arteriovenous fistula was diagnosed, by using conventional ultrasound and were examined by peripheral intravenous contrast-enhanced ultrasound, look left atrium and ventricle and pulmonary arteriovenous blood flow. Results Conventional echocardiography showed that 15 patients in each room, inner chamber is normal, the normal heart valve morphology, activity, continuous normal heart cavity and artery, room, ventricular septal anechoic interruption phenomenon, color doppler no abnormal traffic in the heart cavity blood, 2 cases of right pulmonary veins of thicker, 1 case of aortic valve small regurgitation, 1 case of pulmonary artery widened slightly. Ultrasound imaging showed, right room, right ventricular enhancement after injection of contrast agent, left atrial enhancement after 4 to 5 a cardiac cycle, and can see imaging micro bubble from the pulmonary vein into left atrial, rather than a room, room wear micro bubble insulation, angiography after micro bubble quickly into the left atrium and left ventricle, prompt in all 15 cases pulmonary arteriovenous fistula. Conclusion Through peripheral intravenous contrast-enhanced ultrasound for the diagnosis of pulmonary arteriovenous fistula has a very high value.