经胸超声诊断儿童先天性左心耳瘤

Diagnosis of Congenital Left Atrial Appendage Aneurysm in Children via Transthoracic Echocardiography

目的探讨经胸超声心动图诊断儿童先天性左心耳瘤的图像特点。资料与方法分析2017年7月—2021年4月广州市妇女儿童医疗中心经胸超声心动图诊断并手术或CT确诊的7例先天性左心耳瘤的病例资料及随访结果,总结其声像图特征。结果7例均表现为左前外侧一囊性暗区,多位于心包腔内,壁光整,薄,内有血流与左心房相通,彩色多普勒提示交通口处血流呈双向。7例中,1例为单纯左心耳瘤,手术后预后良好,2例合并近闭合的室间隔缺损,长期随访中,1例合并左心室发育不良综合征放弃治疗后死亡;3例合并复杂性先天性心脏病,均行相应手术治疗,预后良好,所有病例均无明显心律失常,未见明显血栓回声。结论经胸超声心动图可以早期发现并诊断儿童先天性左心耳瘤。

Purpose To explore the transthoracic echocardiographic features in children with congenital left atrial appendage aneurysm.Materials and Methods Seven children with congenital left atrial appendage aneurysm diagnosed by transthoracic echocardiography and confirmed by surgery or CT scan in Guangzhou Women and Children's Center from July 2017 to April 2021 were selected,all clinical data,follow-up data and the ultra-sonographic characteristics were further summarized.Results All seven children were with a cystic dark area on the left anterolateral side,and located in the pericardial cavity with smooth and thin wall.All children were with blood flow communicating with the left atrium,and the Color Doppler suggested that the blood flow at the traffic mouth was bi-directional.Among seven cases,there was exclusively one case with left atrial appendage aneurysm with good performance after surgery,two cases with closing ventricular septal defect during long-term follow-up,one case with hypoplastic left heart syndrome and died after abandoning treatment,and the other three cases were combined with complex congenital heart disease with good prognosis after surgical treatment.No obvious arrhythmia or thrombosis was observed in all cases.Conclusion Transthoracic echocardiography can detect and diagnose congenital left atrial appendage aneurysm in children.