手振50%葡萄糖空气溶液右心声学造影对先天性心脏病的诊断价值

Diagnostic value of right heart contrast echocardiography in congenital heart disease by agitated 50% glucose air solution

目的探讨手振50%葡萄糖空气溶液右心声学造影对先天性心脏病的诊断价值。方法回顾性分析34例接受以手振50%葡萄糖空气溶液行右心声学造影(Right Heart Contrast Echocardiography,RHCE)的资料,并与相应的彩色多普勒血流显像(Color Doppler Flow Imaging,CDFI)结果进行对比;以手术或CT结果为金标准,比较RHCE与CDFI在诊断先天性心脏病的效能。结果 4例CDFI(-)、RHCE(+)病例,并经手术或CT证实为:1例肺动-静脉瘘、1例左位上腔静脉汇入冠状静脉窦,2例卵圆孔未闭。RHCE诊断先天性心脏病的敏感度、特异度高于CDFI[(100.00%、100.00%)vs(66.67%vs 50.00%)]。RHCE诊断先天性心脏病的手术/CT符合率高于CDFI(87.50%vs 75.00%)。结论 RHCE不仅有助于提高分流性先天性心脏病检出率,而且是CDFI的重要补充。

Objective To evaluate the diagnostic value of Right Heart Contrast Echocardiography(RHCE) with agitated 50% glucose air solution for congenital heart disease.Methods Image datas from 34 patients underwent RHCE were retrospectively analyzed. The efficacy of RHCE and CDFI in the diagnosis of congenital heart disease were compared using surgery results or CT as the gold standard. Results 4 cases of CDFI(-) and RHCE(+) were confirmed by surgery or CT: 1 case of pulmonary arteriovenous fistula, 1 case of left superior vena cava confluence into coronary sinus, 2 cases of patent foramen ovalis. The sensitivity and specificity of RHCE in the diagnosis of congenital heart disease were higher than CDFI[(100.00%, 100.00%) vs(66.67% vs 50.00%)]. The operative/CT coincidence rate of RHCE in diagnosing congenital heart disease was higher than CDFI(87.50% vs 75.00%).Conclusion RHCE is not only helpful to improve the detection rate of shunt congenital heart disease, but also an important complement to CDFI.