肺动脉闭锁合并室间隔缺损的影像学诊断及评价

Imaging diagnosis and evaluation of pulmonary atresia with ventricular septal defect

目的:评价肺动脉闭锁合并室间隔缺损(PAVSD)的影像学表现及各种检查方法的应用价值。材料与方法:经心血管造影(CAG)和?或手术证实的PAVSD28例,均行心脏X线平片和超声心动图(UCG)检查,12例行MRI检查。结果:X线平片示肺动脉段直角状凹陷和肺野内局限性肺纹理异常为诊断较特异征象;UCG诊断24例,未能显示中央肺动脉;MRI可显示PAVSD心内结构及中央肺动脉及其发育状况,并可观察到部分粗大侧支血管;经未闭动脉导管造影可显示左、右肺动脉连接处隔膜状狭窄。结论:MRI与X线平片和UCG联合应用,可提高本病无创诊断水平,术前仍需要行CAG检查。

Objective:To evaluate the imaging findings of pulmonary atresia with ventricular septal defect(PAVSD)and the application values of imaging methods.Materials and Methods:Twenty-eight cases of PAVSD confirmed by cardiovascular an-giography(CAG)and*/or surgery were examined by X-ray and echocardiography(UCG),12cases of them were examined by MRI.Results:The right -angle-liked cavity of pulmonary arterial segment and the local abnormal lung markings in the lung field s were diagnostic X-ray signs.Twenty-four cases were diagnosed by echocardiography,but could not show the central pul-monary artery;MRI could show the intracardiac structures,the central pulmonary artery and its developmental condition,fur-thermore could observe enlarged collateral vessels;It could show the membranous stenosis at the junction of left and right pulmonary artery by angiography through the patent ductus arteriosus.Con clu tion:Combination of using MRI ,X-ray and UCG would improve the non-invasive diagnostic level of this disease,but CAG still should be performed before surgery.