超声心动图对肺静脉异位引流的诊断价值及漏误诊分析

Missed diagnosis and misdiagnosis of anomalous pulmonary venous connection by Doppler echocardiography

目的 分析先天性心脏病肺静脉异位引流（APVC）彩色多普勒超声心动图图像特征，评价超声心动图对APVC的诊断价值，分析漏、误诊的原因，提高超声心动图技术对APVC诊断的准确性。方法 选择经心外科手术明确为APVC的22例患儿为研究对象，对其超声心动图检查结果及手术效果进行回顾性分析。结果22例患儿中，超声诊断符合18例（81．8％）；超声误诊2例、漏诊2例（18．2％），其中2例部分型肺静脉异位引流术前超声心动图误诊为房间隔缺损；漏诊的2例患者中，1例漏诊共同肺静脉干梗阻，合并畸形中，1例漏诊动脉导管未闭。22例患儿均合并其他心血管系统畸形。结论超声心动图技术可以诊断APVC，但容易漏误诊。

Objective To assess the significance of Doppler echocardiography in the diagnosis of congeni- tal supravavular mitral ring （APVC） by exploring the manifestations of Doppler echocardiography, and to analyze the misdiagnosed reasons for improving the correct diagnosis. Methods Twenty-two children with APVC con- firmed by surgery were recruited in the study. Doppler echocardiography was performed in all the patients and the relationship of imaging findings and surgical findings were retrospectively analyzed. Results Among all 22 cases, 18 cases （81.8%） were correctly diagnosed as APVC, but 4（ 18.2% ） were missed or misdiagnosed by the echocar-diography, among which 2 cases were missed and 2 cases were misdiagnosed as atrial septal defect. All of 22 patients were complicated with other cardiovascular malformation. Conclusion APVC could be diagnosed by Doppler echocardiography, but easy to miss and misdiagnose.