超声心动图、浅表高频超声及联合使用诊断肺动脉瓣狭窄患儿瓣膜数的价值

Echocardiographic study of pulmonary valve leaflet in children with pulmonary stenosis

目的评价超声心动图联合浅表高频超声探测新生儿及小儿肺动脉瓣狭窄(PS)患儿肺动脉瓣瓣叶数目的效果。方法分别对新生儿及小儿PS患儿的肺动脉瓣进行超声心动图及浅表高频超声二维成像。结果超声心动图、浅表高频超声和超声心动图联合浅表高频超声对明确新生儿及小儿PS患儿肺动脉瓣数目的敏感性分别为81.25%、87.50%和93.75%,特异性分别为75.00%、84.62%和92.31%,准确性分别为73.33%、83.33%和90.00%,阳性预测值为72.22%、82.35%和88.24%,阴性预测值为75.00%、84.61%和92.31%。以手术结果为金标准,超声心动图、浅表高频超声和超声心动图联合浅表高频超声为结果值,分别绘制ROC曲线,曲线下面积分别为0.728、0.830和0.897。结论超声心动图联合浅表高频超声能获得比单用心脏探头更清晰的肺动脉瓣膜二维信息,可为新生儿及小儿PS的瓣膜数目做出更准确判断,从而能为临床提供更可靠的信息。

Objective To evaluate the effect of echocardiography combined with superficial high frequency ultrasound probe in detecting the number of pulmonary valve leaflets in neonates and children with pulmonary stenosis(PS).Methods Echocardiography and superficial high frequency ultrasound were performed in neonates and children with pulmonary valve stenosis.All patients were confirmed by operation.Results The sensitivity of echocardiography,superficial high-frequency ultrasound and echocardiography combined with high frequency ultrasound in neonates and children with pulmonary stenosis to identify pulmonary valve number was 81.25%vs 87.50%vs 93.75%;the specificity was 75.00%vs 86.42%vs 92.31%;the accuracy was 73.33%vs 83.33%vs 90.00%;the positive predictive value was 72.22%vs 82.35%vs 88.24%;negative predictive value was 75.00%vs 84.61%vs 92.31%,respectively.Setting the surgical results as the gold standard and the values of echocardiography,superficial high-frequency ultrasound and echocardiography combined with high frequency ultrasound as the results to draw ROC curve respectively,the area under the curve is 0.728,0.830 and 0.897.Conclusions Echocardiography combined with high frequency ultrasonography can obtain clearer two-dimensional information of the pulmonary valve,and also more accurate assessment of the number of valves for neonates and children with pulmonary valve stenosis and make more accurate judgment to provide more reliable information for clinical than single cardiac probe.